Ki-67抗原对幕上高级别星形细胞肿瘤的预后作用

EXPRESSION AND SIGNIFICANCE OF Ki-67 IN SUPRATENTORIAL ASTROCYTIC TUMORS

目的 :探讨 Ki- 6 7抗原在幕上高级别星形细胞肿瘤中的表达及其预后作用。方法 :使用 S- P免疫组化方法检测 6 3例原发性幕上高级别星形细胞肿瘤标本中 Ki- 6 7抗原的表达。单因素分析使用 Kaplan- Meier法 ,多因素分析使用 COX比例风险模型进行预后分析。结果 :Ki- 6 7指数在组织学分级 级、 级中分别为 (7.32± 3.2 4) %、(7.48± 4.5 5 ) % (P>0 .0 5 )。Ki- 6 7指数≤ 2 .5 %与 >2 .5 %的患者生存期分别为 (4 2 .42± 13.46 )月、(19.95± 11.0 7)月 (P<0 .0 1)。单因素及多因素分析均显示 Ki- 6 7指数是独立的预后因素。结论 :在幕上高级别星形细胞肿瘤中 ,组织病理分级本身对患者预后无意义 ;Ki- 6 7指数与病理级别无关 ;Ki- 6 7指数 >2 .5 %提示预后较差 ;Ki- 6

Objective:To determine the value of Ki 67 labeling index obtained using MIB 1 monoclonal antibody in predicting survival of patients with supratentorial high grade astrocytic tumors.Methods:Ki 67 was determined with immunohistochemistry using monoclonal antibody MIB 1 in 63 patients with supratentorial high grade astrocytic tumor.For the single factor analysis,survival probabilities were estimated based on Kaplan Mier'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 (7.32±3.24) % in GradeⅢ and ( 7.48±4.55 ) % in GradeⅣ( P >0.05) . The mean survival periods with Ki 67 LI≤2.5 % and LI>2.5 % were 42.42±13.46(months),19.95±11.07( months ) , respectively( P <0.01).The single factor and multivariate analysis showed that Ki 67 LI was a significant factor for survival.Conclusion:Histologic grade would provide no useful information for determining the survival of patients with supratentorial high grade astrocytic tumors.There is no relationship between Ki 67 LI and histologic grade.Ki 67 LI>2.5 % is a significant factor for shorter survival.