Ki-67及E-钙粘素在舌鳞状细胞癌中的表达及其临床意义

The clinical significance of Ki-67 label index,E-cadherin expression in tongue squamous cell carcinoma

目的研究舌鳞状细胞癌的Ki-67及E-钙粘素的表达、肿瘤厚度、浸润方式及淋巴细胞浸润程度等因素与颈部淋巴结转移及预后的关系。方法回顾性分析51例舌鳞状细胞癌病例资料,应用免疫组化方法检测肿瘤组织Ki-67、E-钙粘素的表达,同时测量肿瘤厚度、浸润方式、分化程度等病理指标,分析患者临床病理因素及分子表达与颈部淋巴结转移及预后的关系。结果51例患者中,14例出现颈部淋巴结转移,8例随诊期间死亡,用Kaplan-Meier法计算5年生存率为78.1%。E-钙粘素表达与颈部淋巴结转移显著相关(P=0.008),而Ki-67表达及肿瘤浸润方式与病理分化程度相关。Logistic多因素回归分析显示,肿瘤厚度、E-钙粘素表达是颈淋巴结转移的影响因素。单因素分析中预后与T分期、颈淋巴结转移、肿瘤厚度相关,Cox多因素分析颈淋巴结转移是预后的独立因素。结论颈淋巴结转移是舌鳞状细胞癌的独立预后因素,肿瘤厚度及E-钙粘素表达与颈淋巴结转移显著相关,Ki-67表达及浸润方式是肿瘤分化程度的重要指标。

Objective To evaluate the clinical significance of Ki-67 label index and E-cadherin expression,tumor thickness,tumor invasive type,lymphocyte infiltrative type in tongue squamous cell carcinoma.Methods The clinical and pathological data of 51 patients with tongue squamous cell carcinoma were reviewed restrospectively.Immunohistochemistry（IHC）method was applied to detect the expression of Ki-67 and E-cadherin.Tumor thickness,tumor invasive type,lymphocyte infiltrative type and tumor differentiation were associated with clinical lymph node metastasis and prognosis.Results Fourteen patients were found cervical lymph node metastasis out of 51 patients.Eight patients died in the follow-up and the 5-year survival rate was 78.1% with Kaplan-Meier method.High E-cadherin expression significantly lead to high cervical lymph node metastasis rate.Low Ki-67 label index was related to well differentiation.Mutiple regression analysis showed that tumor thickness and E-cadherin expression were associated with lymph node metastasis.In the univariate analysis,the major prognostic factors influencing survival of these patients were T classification,lymph node metastasis and tumor thickness,lymph node metastasis was the only independent prognostic factor in Cox regression.Conclusion E-cadherin expression and tumor thickness is significantly correlated to higher cervical lymph node metastasis.Ki-67 label index and tumor invasive type were important factors considering the tumor differentiation.Regional lymph node metastasis was the independent prognostic factor for tongue squamous cell carcinoma.