Original Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2013; 19(16): 2473-2480
Published online Apr 28, 2013. doi: 10.3748/wjg.v19.i16.2473
Overexpression of carbonic anhydrase II and Ki-67 proteins in prognosis of gastrointestinal stromal tumors
Li-Cheng Liu, Wen-Tong Xu, Xin Wu, Po Zhao, Ya-Li Lv, Lin Chen
Li-Cheng Liu, Wen-Tong Xu, Xin Wu, Lin Chen, Department of General Surgery, General Hospital of PLA, Beijing 100853, China
Po Zhao, Ya-Li Lv, Department of Pathology, General Hospital of PLA, Beijing 100853, China
Author contributions: Liu LC performed the majority of experiments, collected data and wrote the manuscript; Xu WT was in charge of this project, and revised the manuscript and provided financial support for this work; Zhao P and Lv YL provided vital reagents and analytical tools; Wu X and Chen L reviewed the manuscript.
Correspondence to: Wen-Tong Xu, MD, Department of General Surgery, General Hospital of PLA, 28 Fuxing Road, Beijing 100853, China. xuwentong@medmail.com.cn
Telephone: +86-10-66938328 Fax: +86-10-66938327
Received: January 13, 2013
Revised: March 7, 2013
Accepted: March 22, 2013
Published online: April 28, 2013
Abstract

AIM: To investigate the expression and prognostic value of carbonic anhydrase II (CA II) and Ki-67 in gastrointestinal stromal tumors (GISTs).

METHODS: One hundred and thirteen GIST patients admitted to Chinese People’s Liberation Army General Hospital from January 2004 to December 2010 were retrospectively followed up, and immunohistochemistry was used to detect CA II, Ki-67 and CD117 expression in tumor samples. The survival rates of the patients were analyzed using the Kaplan-Meier method. Log-rank test, χ2 test and Cox proportional hazards model were used to determine the relationships between CA II, Ki-67 and CD117 expression and prognostic value in GISTs.

RESULTS: The survival rates at 1, 3 and 5 years were 90.0%, 82.0% and 72.0% in all patients. However, in patients with positive CA II or Ki-67, the survival rates were 92.0%, 83.0% and 77.0% or 83.0%, 66.6% and 53.0%, respectively. Compared with the negative groups, the survival rates in the positive groups were significantly lower (CA II log-rank P = 0.000; Ki-67 log-rank P = 0.004). Multivariate Cox analysis revealed that CA II, CD117 and Ki-67 were considerable immune factors in prognosis of GIST patients (CA II P = 0.043; CD117 P = 0.042; Ki-67 P = 0.007). Besides, tumor diameter, mitotic rate, tumor site, depth of invasion, complete resection, intraoperative rupture, and adjuvant therapy were important prognosis predictive factors. Our study indicated that CA II had strong expression in GISTs and the prognosis of GISTs with high CA II expression was better than that of GISTs with low or no expression, suggesting that CA II is both a diagnostic and prognostic biomarker for GIST.

CONCLUSION: CA II and Ki-67 are significant prognostic factors for GISTs. CA II associated with neovascular endothelia could serve as a potential target for cancer therapy.

Keywords: Gastrointestinal stromal tumors, Carbonic anhydrase, CD117, Ki-67, Prognostic factor

Core tip: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors with a wide spectrum of clinical behavior. This is the first study showing the prognostic significance of carbonic anhydrase II (CA II) and Ki-67. The 1-, 3- and 5-year survival rates were 90.0%, 82.0% and 72.0%. However, in patients with positive CA II or Ki-67, the survival rates were 92.0%, 83.0% and 77.0% or 83.0%, 66.6% and 53.0%, respectively. Our study indicates that CA II has strong expression in GISTs and prognosis with high CA II expression is better than that with low or no expression, suggesting that CA II is both a diagnostic and prognostic biomarker for GIST.