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102例前列腺癌根治术后Ki-67的表达与预后价值分析
作者:张建斌  贺艳锋 
单位:陕西省核工业215医院泌尿外科  陕西 咸阳 712000 
关键词:前列腺肿瘤/外科学 前列腺肿瘤/病理学 Ki-67抗原/代谢 手术后期间 基因表达 免疫组织化学 预后 
DOI:10.13267/j.cnki.syzlzz.2019.01.003
出版年,卷(期):页码:2019,34(1):16-22
摘要:

目的 探讨Ki-67表达与临床病理特征之间的联系,并验证其在预测癌症特异性结果中的价值。方法 使用组织微阵列(tissue microarray,TMA)对102例接受前列腺癌根治术治疗的有完整高质量Ki-67肿瘤数据的前列腺癌患者组织样本进行分析。免疫组织化学染色后,应用核定量算法(Aperio)分析每个癌核(3个癌核/例)肿瘤区域的Ki-67增殖指数(proliferative index,PI)。并评估Ki-67 PI是否与临床病理因素和无复发生存率(recurrence-free survival,RFS)相关,包括生化复发、转移或PC死亡(随访时间中位数为3年)。结果 在102例前列腺癌中,Ki-67 PI显示肿瘤间变异高于肿瘤内变异(0.68 vs 0.39,P<0.05)。Ki-67 PI与肿瘤分期(P<0.01)、精囊浸润(P=0.02)、包膜外扩散(P<0.01)和Gleason评分(P<0.01)相关。在多变量Cox比例危险模型中,Ki-67 PI作为连续变量与无复发、整体和疾病特异性生存率相关(HR=1.04~1.10,均P<0.05)。高Ki-67评分(定义为 ≥ 5%)与RFS(HR=1.47,P=0.001)和总生存率(HR=2.03,P=0.030)较差相关。结论 在前列腺根治术治疗的局限性前列腺癌患者中,较高Ki-67 PI与较高GS、癌症分期、SVI和ECE以及较高的复发率密切相关。

Objective To explore the relationship of Ki-67 proliferative index (PI) with the clinicopathological features and prognosis of patients with prostate cancer after radical prostatectomy. Methods Tissue microarray (TMA) was used to analyze the sample from 102 prostate cancer (PC) patients with complete and high quality Ki-67 data. After immunostaining,the Ki-67 PI of tumor areas was analyzed using a nuclear quantification algorithm (Aperio). Patients were followed up for a median of 3 years. The association of Ki-67 PI with clinicopathological features and recurrence-free survival (RFS) was analyzed. Results In 102 PC patients,the inter-tumor Ki-67 PI was significantly higher than intra-tumor index (0.68 vs 0.39). Ki-67 PI was associated with tumor stage (P<0.01),seminal vesicle invasion (SVI,P=0.02),extracapsular extension (ECE,P<0.01) and Gleason score (GS,P<0.01). Multivariable Cox proportional hazard model showed that Ki-67 PI,as a continuous variable,was significantly correlated with recurrence-free rates,overall survival,and disease specific survival (HR=1.04-1.10,P<0.05). Finally,high Ki-67 score (5% as cutoff point) was significantly associated with decreased RFS (HR=1.47,P=0.001) and overall survival (HR=2.03,P=0.030). Conclusion In patients with localized PC treated by radical prostatectomy,high Ki-67 PI is closely associated with high GS,tumor stage,SVI,ECE and recurrence rate.

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