Ki-67与p27在肾上腺皮质肿瘤中的表达及意义

Expression of Ki-67 and p27 in Adrenocortical Tumor and Its Significance

【目的】研究Ki-67与p27在良恶性肾上腺皮质肿瘤中的表达情况，探讨它们作为鉴别良恶性肾上腺皮质肿瘤的生物学参考指标的可行性。【方法】采用免疫组化法（SP），检测12例正常肾上腺、10例肾上腺皮质腺癌和60例肾上腺皮质腺瘤中细胞增殖标记Ki-67抗原（Ki-67）与细胞周期的负性调控因子p27的表达，并分析它们的表达情况与良恶性肾上腺皮质肿瘤之间的关系。【结果】①Ki-67及p27在正常组与腺瘤组比较差异无显著性（P〉0．05），正常组与腺癌组、腺瘤组与腺癌组的表达差异均有显著性（P〈0．05）；Ki-67腺癌组阳性表达率高于腺瘤组，腺瘤组P27阳性表达率高于腺癌组。②Ki-67表达指数（Ki-67LI）与p27表达指数（p27LI）呈负相关，即在各组的表达中，Ki-67LI越高，p27L1越低。【结论】检测Ki-67和p27可能为鉴别良恶性肾上腺皮质肿瘤提供辅助生物学参考指标。联合检测Ki-67和p27可能提高鉴别良恶性肾上腺皮质肿瘤的敏感性，可以考虑将Ki-67LI〉4％，p27LI〈13％作为肾上腺皮质肿瘤恶性倾向大的辅助参考标准。

[Objective]To study the expressions of Ki-67 and p27 in adrenocortical tumors, and their rela- tionship with adrenocortical carcinoma and adrenocortical adenoma. [Methods] SP immunohistochemistry method was used to detect the expression of Ki 67 and p27 in adrenocortical carcinoma （ n = 10）, adrenocorti- cal adenoma （ n = 60） and normal adrenocortical tissue（ n= 12）. The relationship between the expression of Ki-67 and p27 and adrenocortical carcinoma or adenoma was analyzed. [Results]There was significant differ- ence in the expression of Ki-67 between adrenocortical carcinoma and adrenocortical adenoma, and the positive rate of adrenocortical carcinoma was significantly higher than that of adrenocortical adenoma. There was sig- nificant difference in the expression of p27 between adrenocortical carcinoma and adrenocortical adenoma, and the positive rate of adrenocortical carcinoma was significantly lower than that of adrenocortical adenoma. There was the highest expression of Ki-67 and the lowest expression of p27 in adrenocortical tumors. There existed negative correlation between the expression of Ki 67 and p27 （ P d0.05）. [Conclusion]It is suggested that combined detection of the expression of Ki-67 and p27 may be taken as one of biomarkers for differentiation of adrenocortical adenomas from adrenocorticaL carcinomas . The label index of Ki-67 above 4% and that of p27 below 13 % is a sensitive indicator of adrenocortical carcinoma.