胸苷激酶1和Ki67在乳腺癌中的表达及其对预后的价值

Expression and prognostic significance of TK1 and Ki67 in breast cancer

目的探讨胸苷激酶1（TKl）、Ki67单独表达及联合表达对乳腺癌复发转移的影响。方法选取广州医学院第二附属医院乳腺外科2005年3月至2007年6月问手术切除的乳腺癌患者组织标本65例，均经病理证实。分为A、B两组，A组37例，为乳腺癌在5年内出现复发或转移者，B组28例，为无瘤生存超过5年者。分别测量A、B两组TK1及Ki67表达情况并描述生存曲线。结果TKlA组阳性率为91．8％，B组阳性率67．8％（x2=6．116，P=0．013），Ki67A组阳性率为78．4％，B组阳性率42．9％（X2=8．635，P=0．003）。A、B两组TKl和Ki67均呈阳性表达的比率分别为67．6％和39．3％（x2=5．159，P=0．023）。经Kaplan．Meier法生存曲线证实，与TK1和Ki67单独阳性表达者相比，联合阳性表达者的无瘤生存率显著降低，差异有统计学意义（x2=6．137，P=0．046）。结论TK1、Ki67均阳性表达是乳腺癌复发转移的高危因素，其预后较两者单独阳性表达者更差。

Objective To investigate the effects of the expressions of thymidine kinase 1 （ TK1 ） and Ki67 alone or their combination on the recurrence and metastasis of breast cancer. Methods Sixty-five sam- ples were selected from the Second Affiliated Hospital of Guangzhou Medical University from March 2005 to June 2007, which were resected by surgical operation and confirmed as breast carcinoma by pathology. They were individed into two groups including 37 cases with recurrence or metastasis in 5 years （group A）, 28 cases without recurrence or metastasis in 5 years （ group B）. The expressions of TK1 and Ki67 in the two groups were detected by immunohistochemical staining assay. Then, Kaplan-Meier assay was used to describe survival curve. Results The positive expression rate of TK1 in group A was 91.8%, which was dramatically higher than that in group B 67.8% （X2 = 6. 116, P =0.013）. The positive expression rates of Ki67 in group A and B were 78.4% and 42.9% （X2 = 8. 635, P = 0.003）. The positive expression rates of TK1 combined with Ki67 in group A and B were 67.6% and 39.3% （X2 = 5. 159, P = 0. 023 ）. Moreover, disease free survival of patients with positive expression of TK1 combined with Ki67 decreased significantly, compared with patients with positive expression of TK1 or Ki67 alone （X2 = 6. 137, P = 0. 046）. Conclusion Positive expression of TKt combined with Ki67 is the high risk factor of the reccurence or metastasis of breast carcinoma, and indi- cates poorer prognosis compared with positive expression alone.