Ki-67表达在早期皮肤黑色素瘤的预后分析

Ki-67 expression in 398 cases of cutaneous melanoma and its clinical features and prognosis

目的探索Ki-67表达水平对早期皮肤黑色素瘤患者的生存预后是否有影响。方法回顾分析北京大学肿瘤医院肾癌黑色素瘤内科收治的Ⅰ~Ⅲ期皮肤黑色素瘤患者,将Ki-67以25%表达水平分为4组,分别用0(0~24%)、1(25%~49%)、2(50%~74%)和3(≥75%)表示。同时收集患者临床资料(包括患者年龄、性别、原发灶部位、肿瘤厚度、溃疡,Clark分级、基因突变、AJCC第8版分期、乳酸脱氢酶水平、ECOG分级,是否干扰素辅助治疗等)及其生存信息。对不同Ki-67水平与预后进行相关性分析。结果共计306例患者被纳入分析中,全组患者中位年龄48岁,中位随访时间41个月。Ki-67表达0~3组患者比例分别为53.9%、29.4%、14.1%和2.6%;4个组的无复发生存时间(RFS)分别为42、33、18、4个月(P<0.001);4个组总生存(OS)期分别为NA、72、35、19个月(P<0.001)。Ki-67表达水平以25%为连续变量进行多因素回归分析,RFS的HR=1.43(95%CI为1.13~1.80,P=0.002);OS的HR=1.61(95%CI为1.20~2.15,P=0.001)。结论Ki-67表达与早期皮肤黑色素瘤的预后相关。Ki-67表达水平越高预后越差,Ki-67有可能成为中国早期皮肤黑色素瘤独立预后因素。

Objective To investigate whether Ki-67 expression level has an impact on survival prognosis in patients with early stage cutaneous melanoma.Method Peking University cancer hospital were retrospectively analyzed internal medicine treated kidney cancer melanoma patients with stageⅠ~Ⅲskin melanoma,Ki-67 expression level at 25%can be divided into four groups,respectively 0(0~24%),1(25%~49%),2(50%~74%)and 3(≥75%),while collecting patients clinical data,including patient age,gender,primary focal position,tumor thickness,ulceration,Clark,grading,gene mutation,eighth edition AJCC staging,LDH level and grade of ECOG,whether the adjuvant treatment of interferon,etc.)and their survival information.To analyze the correlation between different Ki-67 levels and prognosis.Results A total of 306 patients were included in the analysis,with a median age of 48 years in the whole group and a median follow-up time of 41 months.The proportions of Ki-67 expression in 0~3 group were 53.9%,29.4%,14.1%and 2.6%,respectively.Relapse-free survival(RFS)was 42,33,18 and April(P<0.001).The total survival time(OS)of the 4 groups was NA,72,35 and 19 months(P<0.001).The expression level of Ki-67 was analyzed by multi-factor regression with 25%as the continuous variable,and HR=1.43(95%CI:1.13~1.80,P=0.002).OS HR=1.61(95%CI:1.20~2.15,P=0.001).Conclusions Ki-67 expression is associated with the prognosis of early cutaneous melanoma.The higher the Ki-67 expression level,the shorter the survival time and the worse the prognosis,and Ki-67 may be an independent prognostic factor for early stage skin melanoma in China.