眼睑基底细胞癌细胞DNA倍体及核增殖抗原蛋白表达

DNA ploidy and Ki67 expression in eyelid basal cell carcinoma

目的研究眼睑基底细胞癌细胞DNA倍体及核增殖抗原(Ki67)蛋白表达对眼睑基底细胞癌临床预后的意义。方法收集接受肿瘤切除术的眼睑基底细胞癌患者23例,采用细胞图像光度术(image cytometer, ICM)和免疫组织化学技术分别检测眼睑基底细胞癌细胞DNA倍体和Ki67蛋白表达状况。结果二倍体与异倍体发生率的差异无统计学意义(P>0．05),二倍体与异倍体患者性别比、年龄及肿瘤大小的差异均无统计学意义(P值均>0．05)。所有患者癌细胞Ki67表达指数平均为0．243±0．021,其中二倍体平均为0．177±0．023,异倍体平均为0．268±0．021,两者的差异无统计学意义(P=0．142)。3种临床类型之间的差异亦无统计学意义(P值均>0．05)。术后随访的18例患者中,10例局部复发,无一例发生远处转移。局部复发者中异倍体发生率为9／10例,显著高于无复发者的3／8例(P=0．043)。复发患者癌细胞Ki67表达指数平均为0．272±0．134,无复发患者平均为0．197±0．019,两者的差异无统计学意义(P=0．069)。结论眼睑基底细胞癌细胞DNA异倍体可能与术后复发有关,故在临床治疗上应考虑对该类型患者采取相应措施。

Objective To investigate the prognostic significance of DNA ploidy and Ki67 expression in eyelid basial cell carcinoma. Methods A total of 23 cases of eyelid basal cell carcinoma were studied for the expression of Ki67 by immunohistochemistry, and DNA ploidy determined by image cytometer（ICM）. Results Of the 23 cases of eyelid basal cell carcinoma, DNA aneuploidy was seen in 15 cases （65.2%）, presenting as 90 % in recurrent basal cell carcinoma following treatment but it was only 37.5% in nonrecurrent cases, this difference was statistically significant （P = 0. 043）. The labeling indexes of Ki67 expression were 0. 272 ± 0. 134 in recurrent tumors vs 0. 197±0. 019 in nonrecurrent ones. There was a notable increase in the percentage positive for Ki67 in recurrent tumors as comparing with the nonrecurrent tumours, showing no statistical significance （P = 0. 069）. Conclusions Aneuploidy in eyelid basial cell carcinoma would be probably a warning sign for recurrences, arousing for corresponding treatment. （Shanghai Med J, 2007, 30 ： 111-113）