Ki-67对弥漫大B细胞淋巴瘤预后评估的意义

Prognostic value of Ki-67 protein in patients with diffuse large B-cell lymphoma

目的:探讨Ki-67蛋白在弥漫大B细胞淋巴瘤(DLBCL)组织中的表达情况及其对患者预后的意义。方法:采用EliVision plus免疫组织化学二步法测定85例DLBCL患者肿瘤组织中Ki-67蛋白的表达,前瞻性调查分析其与临床特征及疗效的关系。结果:85例DLBCL患者中36例(42.4%)肿瘤组织呈Ki-67蛋白高表达。Non-GCB组Ki-67高表达率为56.1%,GCB组Ki-67高表达率为29.5%,差异有统计学意义(P<0.05)。中位随访24个月后,生存分析显示Ki-67高表达组中位疾病无进展生存时间(PFS)为18个月,短于Ki-67低表达组31个月,两组PFS差异有统计学意义(P<0.05)。Ki-67高表达组接受R-CHOP方案化疗PFS长于CHOP方案组,差异有统计学意义(P<0.05),在Ki-67低表达组未观察到两种化疗方案PFS差异有统计学意义(P>0.05)。结论:Ki-67对判断弥漫大B细胞淋巴瘤预后及选择治疗方案均有较好的指导意义。

Objective：To evaluate the expression of Ki-67 protein in patients with diffuse large B-cell lymphoma（DLBCL） so as to analyze the clinical utility of Ki-67 for predicting prognosis.Method：The expression of Ki-67 was measured in 85 patients with DLBCL by EliVision plus method.Its relationship to clinical feature and prognosis was studied.Result：High-level expression of Ki-67 was found in 36（42.4%） of the 85 DLBCL patients.The high Ki-67 expression rate in non-GCB group was higher than that in GCB group（56.1% vs 29.5%,P〈0.05）.The median of 24-months follow-up research revealed that progression-free survival（PFS） was significantly lower（P〈0.05） in the high Ki-67 expression group than in the low Ki-67 expression group（median,18 vs 31 months）.Patients with high Ki-67 expression had lower PFS（P〈0.05） when they were treated with R-CHOP regiment compared with standard CHOP regiment.On the other hand,PFS was similar between R-CHOP and CHOP groups in patients with low Ki-67 expression（P〉0.05）.Conclusion：Ki-67 can be used for predicting prognosis in patients with DLBCL.High Ki-67 expression is associated with non-GCB immunology type of DLBCL and poor survival.R-CHOP might be preferable to CHOP in patients with high Ki-67 expression.