有丝分裂核碎裂指数在节细胞神经母细胞瘤预后评价中的意义及其与Ki67表达的相关性

Relationship between the Expression of Ki67 and Mitosis Karyorrhexis Index in Ganglioneuroblastoma

目的探讨有丝分裂核碎裂指数(MKI)在节细胞神经母细胞瘤(GNB)预后评价中的意义及其与细胞增殖抗原标记物Ki67的相关性。方法收集28例GNB的标本和临床资料。显微镜下计数每例标本的MKI,应用免疫组织化学方法检测每例标本中Ki67蛋白的表达。根据2003年国际神经母细胞瘤病理分类标准进行病理分型和统计学分析。结果 28例GNB预后良好型15例,预后不良型13例。随访28例,失访1例。预后良好型GNB患者组生存时间明显高于预后不良组(P<0.05),生存时间与病理分型显著相关(P<0.05)。MKI与临床分期、病理分型以及生存时间相关(P<0.05)。高MKI组与低MKI组相比,Ki67表达无显著差异。结论在GNB的病理分型和预后评价中,MKI是一个显著的预后评价指标,单独检测Ki67对预后评价意义不大。

Objective To explore the relationship between the expression of Ki67 and mitosis karyorrhexis index（MKI）in ganglioneuroblastoma（GNB）.Methods Clinical materials and histology slides from 28 patients with GNB were reviewed.MKI was counted under microscope and the expression of Ki67 protein in GNB was evaluated by immuohistochemical technique.The follow-up data were also collected and statistically analyzed.Results There were 15 patients with favourite prognosis（favourite subgroup,FS） and 13 patients with poor prognosis（unfavourite subgroup,US）.The survival time of GNB patient in FS was significantly longer than that in US（P 0.05）.The survival time is related to pathology classification（P 0.05）.MKI was correlated with advanced clinical stage,pathology classification and survival time（P 0.001）.No significant difference in Ki67 expression was found between low and high MKI patients.Conclusion MKI might be a reliable prognostic parameter for making diagnosis and evaluating prognosis of GNB.Detection of Ki67 expression might be not useful for evaluating the prognosis of GNB.