儿童脑胶质瘤Ki-67抗原表达及其意义

Expression and significance of Ki-67 antigen in pediatric brain glioma

目的研究Ki-67抗原在儿童脑胶质瘤中的表达与不同病理分类分级、肿瘤生长部位的关系。方法对62例不同病理分类分级的儿童脑胶质瘤进行Ki-67免疫组织化学染色,观察Ki-67标记指数及染色程度。结果胚胎性肿瘤的Ki-67标记指数(Ki-67LI)显著高于其他脑胶质瘤(P<0.05);幕上胶质瘤的Ki-67LI显著低于幕下胶质瘤(P<0.05);Ki-67LI随脑胶质瘤恶性程度级别增高呈上升趋势,其中Ⅰ、Ⅱ、Ⅲ级的Ki-67LI显著低于Ⅳ级(P<0.05),且Ⅰ级的Ki-67LI显著低于Ⅲ级(P<0.01);低级别胶质瘤(Ⅰ级和Ⅱ级)的Ki-67LI显著低于高级别胶质瘤(Ⅲ级和Ⅳ级)(P<0.01);低级别胶质瘤(Ⅰ级和Ⅱ级)的Ki-67阳性细胞核染色程度明显弱于高级别胶质瘤(Ⅲ级和Ⅳ级)(P<0.01)。结论Ki-67抗原是反映儿童脑胶质瘤细胞增殖活性较可靠的细胞增殖指标,可以为小儿脑胶质瘤病理分类分级提供一种有效的辅助方法,有助于更加客观地评价患儿的预后。

Objective To study the relationship between the expression of Ki-67 antigen and the differences in pathological types, grades, and locations of pediatric brain glioma. Methods Sixty-two samples of glioma with various pathological types and grades were examined by labeling index and staining intensity of Ki-67 with immunohistochemical technique. Results The expression of Ki-67 LI in supratentorial gliomas was significantly lower than those in subtentorial gliomas （P 〈 0.05 ）. The expression of Ki-67 LI increased with the pathological grade, Ki-67 LI level was significantly higher in embryonic type than that in all other types （P 〈 0.05 ）, Ki-67 LI levels were significantly lower in grade Ⅰ , Ⅱ , and m than that in grade Ⅳ （P 〈 0.05 ）, Ki-67 LI level was significantly lower in grade Ⅰ than that in grade m （P 〈 0.01 ） . The Ki-67 LI level and the nuclear staining were significantly lower in low-grade malignant glioma （grade Ⅰ and Ⅱ ） than those of high-grade malignant glioma （grade Ⅲ and Ⅳ ） （P 〈 0.05）. Conclusions Ki-67 antigen is a reliable marker reflecting the proliferating activity in pediatric brain glioma. It can be used as an effective auxiliary method for pathological typing and grading for brain glioma in childhood and it helps to evaluate the prognosis more objectively.