DOG1 pozitifliği tanıda yüksek özgüllüğe sahiptir. DOG1, klinik olarak GİST şüphesi olan, tümör c-kit ekpresyonu negatif olan hem erken hem de ileri evre hastaların tanısında önemli bir araç olarak görülmektedir. DOG1 boyanması ile prognoz arasında gösterilmiş herhangi bir çalışma bulunmazken, bizim çalışmamızda ileri evre hastalarda DOG1 negatif olmasıyla kısa sağkalımla sınırda bir anlamlılık saptanmıştır, ancak bu kontrollü çalışmalarla valide edilmelidir.
Mitoz sayısının >10 olmasının primer cerrahi sonrası takipli erken evre hastalarda kötü prognostik faktör olarak belirlenmiştir.
Sadece hücre siklusunda M safhasını gösteren mitotik indeks yerine; G1, G2, S ve M fazında da proliferasyonu işaret eden Ki-67 proliferasyon indeksinin kullanımı daha geniş bakış açısı sağlayabileceği ve mitozun 50 BBA’nında değerlendirilmesindeki standartizasyon sorunlarından dolayı Ki-67’nin pratiklik kazandırabileceği hipotetik olarak mantıklı görülmektedir. Çalışmamızda Ki-67 proliferasyon indeksinin prognozla anlamlı bir ilişki saptanmamasına rağmen; rekurrens risk skorunu gösteren mitotik indeks ile korelasyon göstermektedir. Her ne kadar cerrahi sonrası rekurrens skorlarında Ki-67’nin skorlama sistemine dahil edilmesi sisteme pratiklik kazandırabileceği düşünülse de bu konuda bir iddiada bulunmak için daha fazla sayıda hastada Ki-67 ekspresyonu bakılmalı ve diğer rekurrens ön gördüren faktörlerle birlikte değerlendirilmelidir. Mevcut verilerle, biz şu an için NIH 2002 konsensusu içerisinde yer alan proliferasyonu gösteren mitotik indeks yerine Ki-67’nin kullanılmasını önermemekteyiz.
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