Prognostic value of Ki67 index in gastrointestinal stromal tumors

Int J Clin Exp Pathol. 2014 Apr 15;7(5):2298-304. eCollection 2014.


Background: Ki67 index is one of the most important immunocytochemical markers of proliferation in tumors, but the criterion of Ki67 index in GISTs was not well-defined yet. Our study aims to fully evaluate the prognostic value of Ki67 index in GIST patients and efficiency of imatinib adjuvant therapy.

Methods: Clinicopathological data were confirmed by pathological diagnosis and clinical recorders. Recurrence-free survivals (RFS) were evaluated in 418 GIST patients (370 cases only taken the surgery and 48 high-risks taken imatinib adjuvant therapy after R0 resection).

Results: Two cutoff levels of Ki67 index (>5 and >8%) were established in our study through statistical analysis. Ki67 index (≤5, 6-8 and >8%) is an independent prognostic factor for RFS of GIST patients. Ki67 index>8% can precisely sub-divide high-risk GISTs effectively with different outcomes, and high-risk patients with Ki67 index>8% showed a poorer prognosis even with imatinib adjuvant therapy.

Conclusion: Ki67 index is an effective complementation of modified NIH criteria in predicting the prognosis of GISTs, and Ki67 index>8% may act as an unfavorable factor for imatinib adjuvant therapy.

Keywords: Gastrointestinal stromal tumor; Ki67; prognosis; targeted therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Benzamides / therapeutic use
  • Biopsy
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Gastrointestinal Stromal Tumors / chemistry*
  • Gastrointestinal Stromal Tumors / mortality
  • Gastrointestinal Stromal Tumors / therapy
  • Humans
  • Imatinib Mesylate
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Ki-67 Antigen / analysis*
  • Male
  • Middle Aged
  • Mitotic Index
  • Piperazines / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / therapeutic use
  • Risk Factors
  • Time Factors
  • Tissue Array Analysis
  • Treatment Outcome


  • Antineoplastic Agents
  • Benzamides
  • Ki-67 Antigen
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate