脊索瘤组织中C-Met和Ki-67表达及临床病理意义

Expression of C-Met and Ki-67 in chordoma and its clinical significance

目的探讨肝细胞生长因子受体(C-Met)和Ki-67在脊索瘤组织中表达的意义。方法回顾性分析51例经手术治疗的脊索瘤患者临床病理资料,并用免疫组化EnVision两步法检测C-Met和Ki-67在脊索瘤中的表达。结果 C-Met阳性表达定位于细胞质,在经典型脊索瘤(typical chordoma,TC)、软骨样型脊索瘤(chondroid chordoma,CC)、去分化型脊索瘤(dedifferen-tiated chordoma,DC)中阳性率分别为70.1%、58.3%、80%。C-Met的表达水平与肿瘤的复发密切相关。Ki-67阳性表达定位于细胞核,所有病例中Ki-67增殖指数均不高(<20%)。生存分析Log-rank检验显示组织学分型、手术切除程度、C-Met和Ki-67表达水平对生存率有明显影响(P<0.05);多因素Cox回归分析显示Ki-67是影响患者生存率的独立性预后因素(P<0.05)。结论 C-Met和Ki-67可作为脊索瘤患者预后评估的有效指标。C-Met高表达提示患者存在高复发风险,且预后不良,临床需加强患者术后治疗及随访。Ki-67是影响患者预后的独立性因素,其增殖指数高(>5%),提示患者预后较差。

Purpose To investigated the significance of the expression of C-Met and Ki-67 in chordoma. Methods The clinicopatho- logical characteristics of 51 cases of chordoma were retrospectively reviewed. All the cases were chosen for immunohistochemical stai- ning with antibodies against C-Met and Ki-67 proteins, and the clinical significance of these immunohistochemical markers was ana- lyzed. Results The positive expression of C-Met localized in the cytoplasm, and Ki-67 localized in the nucleus. C-Met was positive in 70. 1% of typical chordoma （ TC）, 58.3 % of chondroid chordoma （ CC ）, 80% of dedifferentiated chordoma （ DC ）. The overall ex- pression of Ki-67 level was low and no case was higher than 20%. C-Met expression was correlated with the recurrence （ P 〈 0.05 ）. In survival analysis, Log-rank test showed pathological subtype, resection degree, C-Met and Ki-67 expression were unfavorable factors for survival （P 〈 0.05 ）. Cox regression analysis showed that Ki-67 expression was independent factors that affect on the patient＇ s survival （ P 〈 0. 05 ）. Conclusion Combination of C-Met and Ki-67 can be used for the prognosis of chordoma. C-Met could act as a marker to help to predict the tumor recurrence and the high expression of C-Met indicates that there is high likelihood of recurrence, suggesting that intensive therapy and frequent follow-up should be performed. Chordoma with higher Ki-67 index （ 〉 5% ） was independent factors for a more aggressively clinical course and poorer survival.