Ki-67抗原与子宫颈鳞癌新辅助化疗和放疗的敏感性研究

Association of Ki-67 expression with sensitivity of neoadjuvant chemotherapy and radiotherapy in cervical squamous cell carcinoma

目的探讨Ki-67抗原与子宫颈鳞癌新辅助化疗(NACT)和放射治疗(RT)的敏感相关性。方法在新辅助化疗前后用免疫组化检测32例宫颈鳞癌组织Ki-67的表达。结果化疗前患者Ki-67的表达水平在不同年龄段组(<45岁和≥45岁)、不同临床期别组(Ⅰb～Ⅱa和Ⅱb～Ⅲb)和不同病理分级组(高中分化和低分化)之间相互比较差异有统计学意义(P=0.008、0.009、0.000)。化疗后患者Ki-67表达水平与化疗前比较明显下降,差异有统计学意义(P=0.000)。化疗前Ki-67表达程度不同,化疗和化放疗的疗效明显不同,化疗疗效高表达组与低表达组比较差异有统计学意义(P=0.033);化放疗疗效高表达组与低表达组比较差异无统计学意义(P=0.375);高表达组、低表达组对化疗和化放疗的疗效比较差异均有统计学意义(P=0.001、0.000)。结论子宫颈鳞癌治疗前Ki-67表达强度与化疗敏感性呈正相关;虽然存在Ki-67阳性表达强度愈强、NACT+RT的完全缓解率愈高的趋势,但未显示明显的放射敏感相关性;治疗前检测Ki-67表达可以为预测化疗和放疗敏感性提供客观依据,但Ki-67能否确定为预测子宫颈鳞癌新辅助化疗和放疗敏感性的可靠指标还需增加样本作进一步研究。

Objective To investigate the association of Ki-67 expression and the sensitivity of neoadjuvant chemotherapy（NACT）and radiotherapy（RT）in cervical squamous cell carcinoma.Methods The expression of Ki-67 antigen was detected with immunohistochemical method before and after neoadjuvant chemotherapy in 32 cases of cervical squamous cell carcinoma.Results Before chemotherapy Ki-67 expression levels were statistically significantly different in patients with different age,different clinical stage and different pathological classification（P=0.008,0.009,0.000）.The expression of Ki-67 decreased after chemotherapy（P=0.000）.The efficacy of chemotherapy was significantly different between patients with high Ki-67 expression and with low Ki-67 expression（P=0.033）,while there were no differences for chemoradiotherapy between two groups（P=0.375）.The efficacy of chemotherapy and chemoradiotherapy between low and high Ki-67 expression groups were statistically different（P=0.001,P=0.000）.Conclusions The expression of Ki-67 has positive correlation with sensitivity of chemotherapy in cervical squamous cell carcinoma,however,there was no correlation for radiosensitivity.To detect the Ki-67 expression in pre-treatment can provide objective prediction for sensitivity of chemotherapy and radiation.