Ki67在乳腺癌中的表达及临床意义

Expression of Ki67 and clinicopathological features in breast cancer

目的探讨Ki67指数与乳腺癌其他临床病理指标的关系。方法回顾性分析中国医学科学院肿瘤医院2010年1月至2010年12月收治的918例女性乳腺浸润性导管癌患者的临床病理资料，分析Ki67指数与乳腺癌其他临床病理指标的关系。结果918例女性乳腺癌患者的Ki67指数为0．9％-95％，平均为27．8％。以Ki67指数14％为界将患者分为2组，其中Ki67指数≤14％者263例（28．6％），Ki67指数〉14％者655例（71．4％）。患者年龄、肿瘤T分期、腋窝淋巴结转移状态、组织学分级、雌激素受体（ER）状态、孕激素受体（PR）状态和人表皮生长因子受体2（HER-2）状态均与Ki67指数有关（均P〈0．05）。Luminal B型、HER-2过表达型和三阴性乳腺癌的Ki67指数分别为30．44％、36．77％和47．40％，均高于Luminal A型（21．36％，P〈0．01）。三阴性乳腺癌Ki67指数（47．40％）高于非三阴性乳腺癌（24．79％，P〈0．001）。结论Ki67指数与患者年龄、肿瘤T分期、腋窝淋巴结转移状态、组织学分级、ER状态、PR状态和HER-2状态均有关，有望成为判断乳腺癌预后的重要指标。

Objective To analyze the relationship between the expression level of Ki67 and clinicopathological features in breast cancer. Methods Data of 918 female patients with invasive ductal breast carcinoma treated in the Cancer Hospital, Chinese Academy of Medical Sciences from Jan. to Dec. 2010 were analyzed retrospectively. The correlation of Ki67 expression and other clinicopathological features in the breast cancer was analyzed. Results Among the 918 cases, the Ki67 index was 0. 9% to 95% （mean value 27. 8% ）. Taking the Ki67 index 14% as the boundary to divide the patients into two subgroups, 263 cases （28.6%） were ≤ 14%, and 655 cases （71.4%） were 〉 14%. There were significant differences between the Ki67 expression and age, tumor size, axillary lymph nodes status, histological grade and the expressions of C-erbB-2, estrogen receptor （ER） and progesterone receptor （PR） （ P 〈 0. 05 for all）. All the Ki67 indexes of Ki67 expression in luminal B （30.44%）, HER-2 overexpression （36. 77% ） and triple negative （47. 40% ） subtypes were significantly higher than that in the luminal A subtype （21.36% ） （P 〈 0.01 ）. The expression level of Ki67 in triple-negative subtype （47.40%） was significantly higher than that in the non-triple-negative subtype （24. 79% ） （P 〈 0. 001 ）. Conclusions Ki67 index is significantly correlated with the age, tumor TNM stage, axillary lymph node status, histological grading, ER status, PR status and HER-2 status. A high expression level of Ki67 is a poor prognostic factor for breast cancer. The expression level of Ki67 should be detected routinely and it may become a useful prognostic marker in the treatment of breast cancer.