CD133在原发性腹膜后平滑肌肉瘤中的表达及其与Ki-67的关系

Expression of CD133 in primary retroperitoneal leiomyosarcoma and its relationship with Ki-67

目的 评判肿瘤干细胞标志物CD133和核增殖标志物Ki-67与原发性腹膜后平滑肌肉瘤的临床病理特征相关性,并评判其预后价值.方法 收集2000年1月至2012年12月解放军总医院病理科50例经术后病理确诊为原发性腹膜后平滑肌肉瘤的病理蜡块,其中男9例、女41例,年龄27～ 75岁,中位年龄49岁,所有的患者均有完整的随访资料.运用免疫组织化学PV6000两步法,检测并分析原发性腹膜后平滑肌肉瘤组织中CD133和Ki-67蛋白的表达.结果 50例原发性腹膜后平滑肌肉瘤样本中,37例（74.00％） CD133蛋白检测阳性.组织学等级为Ⅰ级和Ⅱ级的肿瘤组织中CD133阳性率分别为7/13和76.70％（23/30）,7例Ⅲ级肿瘤样本全部阳性表达.CD133的表达与肿瘤大小,核分裂数和组织学分级均有相关性（x^2=4.925、4.525、10.080,P=0.026、0.033、0.013）.CD133阳性患者术后生存时间[M（Q1,Q3）]为32（17,56）个月,短于阴性患者44（26,65）个月.42例Ki-67表达阳性（84.00％）,其表达水平与核分裂计数有相关性（x^2=9.950,P=0.041）.CD133的表达与Ki-67的表达相关（x^2=13.511,P=0.009）,Log-rank检验发现CD133、Ki-67的阳性表达与患者5年生存率均存在相关性（P =0.021、0.049）.多因素分析表明,CD133、核分裂计数是原发性腹膜后平滑肌肉瘤的独立预后指标（HR=2.040、2.422,P=0.000、0.018）.结论 CD133可能在原发性腹膜后平滑肌肉瘤的进展中发挥重要作用,可作为独立标志物用于评估腹膜后平滑肌肉瘤患者的预后.联合检测CD133和Ki-67的表达,能更可靠地预测腹膜后平滑肌肉瘤患者的预后.

Objective To explore the correlation between CD133 and proliferative marker Ki-67 in primary retroperitoneal leiomyosarcoma and evaluate their prognostic values.Methods A total of 50 primary retroperitoneal leiomyosarcoma samples were collected at our hospital from January 2000 to December 2012.There were 9 males and 41 females.All samples were analyzed for CD133 and Ki-67 protein expression by PV6000 immunohistochemistry.Their median age was 49 （27-75） years.All cases were successfully followed up.Results CD133 expression was detected in 74.00％ （37/50） of primary retroperitoneal leiomyosarcoma samples.The CD133-positive rates of histological grades Ⅰ ＆ Ⅱ primary leiomyosarcoma were 7/13 and 76.70％ （23/30） respectively.All grade Ⅲ samples （n =7） were CD133 positive.And the expression of CD133 had a positive correlation with tumor size,mitotic counts and histological grade （x2 =4.925,4.525,10.080 ; P =0.026,0.033,0.013）.The survival time of CD133-positive patients with M（Q1,Q3） was 32（17,56） months versus 44 （26,65） months for those negative ones.The expression of Ki-67 was detected in 84.00％ （42/50） of primary retroperitoneal leiomyosarcoma samples and its expression showed a positive correlation with mitotic counts.The expressions of CD133 and Ki-67 were positively correlated in primary retroperitoneal leiomyosarcomas （P =0.009）.Log-rank test showed that positive expressions of CD133 and Ki-67 and 5-year patient survival rate were correlated （P =0.021,0.049）.Multivariate analysis showed that CD133 and mitotic counts were independent prognostic indicators for primary retroperitoneal leiomyosarcomas （HR =2.040,2.422; P =0.000,0.018）.Conclusions CD133 plays an important role in the progression of primary retroperitoneal leiomyosarcomas so that it may be used as a marker for patient prognosis.Combined detection of CD133 and Ki-67 has a prognostic value in patients with primary retroperitoneal leiomyosarcoma.