Ki-67抗原在人脑星形细胞肿瘤中的表达及其对预后的意义

EXPRESSION AND SIGNIFICANCE OF Ki-67 IN ASTROCYTIC TUMORS

目的 :探讨 Ki- 6 7抗原在人脑星形细胞肿瘤中的表达及其对预后的意义。方法 :原发性星形细胞瘤89例。使用 S- P免疫组化方法检测手术切除标本石蜡块的 Ki- 6 7抗原 ,并算得 Ki- 6 7指数。生存分析单因素使用Kaplan- Meier法计算生存率并采用 logrank(对数秩 )检验。多因素分析使用 COX比例风险模型 ,采用逐步回归分析。结果 :Ki- 6 7L I在组织学分级 Grade 、 、 中分别为 2 .6 7%± 1.6 2 % ,6 .71%± 3.89% ,8.0 7%± 3.84%。三组间有显著性差异 (P<0 .0 1)。单因素分析结果显示组织学分级、Ki- 6 7指数等因素与患者预后有关 (logrank<0 .0 1)。在 Grade 中 ,Ki- 6 7指数 >2 .5 %与 Grade 中 Ki- 6 7指数≤ 2 .5 %的患者生存期差异无显著性 (P>0 .0 5 ) ;在Grade 中 ,Ki- 6 7指数≤ 2 .5 %与 >2 .5 %的患者生存期有显著性差异 (P<0 .0 1)。结论 :Ki- 6 7指数随着各病理级别增高而增高 ;Ki- 6 7指数 >2 .5 %提示预后较差。在同一病理级别中 ,Ki- 6 7指数不同 ,其预后有显著性差异。联合利用组织病理检查及 Ki- 6

Objective:To explore the prognostic factors for patients with astrocytic tumors and to determine the value of Ki-67 labeling index obtained using MIB-1 monoclonal antibody in predicting survival.Methods:Data of 89 patients with astrocytic tumors were collected enrolled in Nantoing Medical College affiliated hospital from 1994 to 1996.Ki-67 was determined with immunohistochemistry using monoclonal antibody MIB-1.For the univariate analysis,survival probabilities were estimated based on Kaplan-Meier's Product-Limit Survival Estimates method and logrank test was used to assess the association between patient survival and each variable.Multivariate regression analysis using Cox's proportional-hazards model was used to ascertain a simultaneous effect of outcome-related variables on survival.Results:the mean Ki-67 LIs were 2.67%±1.62% in GradeⅡ,6.74%±3.89% in GradeⅢ and 8.07%±3.84% in GradeⅣ.Analysis of variance indicated a significant difference among them.Univariate analysis showed that histologic grade and Ki-67 LI were significant factors for survival.Conclusion:There is a strong positive relationship between Ki-67 LI and histologic grade.The higher histologic grade,the higher Ki-67 LI.And Ki-67 LI>2.5% is a significant factor for shorter survival.In the same histologic grade,there is a significant difference in patients' prognosis due to the different Ki-67 LI.Whereas,with the different Ki-67 LI,some patients with different histologic grade have no significant survival time.Ki-67 LI and histologic grade detected together will provide more accurate useful information for determining the patients' prognosis. [