乳腺癌Ⅰ、Ⅱ组淋巴结Ki67定性、定量表达差异及相关分析

Qualitative and quantitative differences of Ki67 between levels Ⅰ and Ⅱ lymph nodes in breast cancer,and its correlation analysis

目的:分析乳腺癌Ki67在不同临床病理特征及Ⅰ、Ⅱ组淋巴结的表达差异和相关关系,探讨其临床意义。方法:采用免疫组织化学法测定42例原发性浸润性乳腺导管癌Ki67定量(Ki67数值)及定性(阳性/阴性)表达,并与Ⅰ、Ⅱ组淋巴结转移、数目、位置、MRI增强所示淋巴结短径及相关临床病理特征对比分析。结果:Ⅰ、Ⅱ组淋巴结阳性受累率分别为74. 07%和13. 33%。定性分析示,仅不同淋巴结短径的Ki67表达差异有统计学意义(P <0. 01)。定量分析示,转移淋巴结Ki67表达(46. 19±5. 40)明显高于无转移淋巴结(31. 19±4. 79),淋巴结短径≥0. 7 cm的Ki67表达(43. 33±4. 60)明显高于短径<0. 7 cm(19. 17±3. 32)(P <0. 01)。较低年龄(<45岁)和肿瘤低分化(WHOⅢ级)的Ki67阳性表达较高(P <0. 01)。WHOⅠ～Ⅱ级组与WHOⅢ级组间Ki67表达呈显著相关(r=0. 722,P <0. 01)。Ki67表达与Ⅰ～Ⅱ组淋巴结个数均无相关关系(P> 0. 05),与Ⅰ组淋巴结转移及转移阳性率呈相关关系(r=0. 453、0. 458,P <0. 01),与Ⅰ组淋巴结短径呈显著相关关系(r=0. 689,P <0. 01)。结论:Ki67有助于评估乳腺癌组织学分级、Ⅰ组淋巴结短径及转移,具有重要的临床意义和应用前景。

Objective： To analyze the expression differences of Ki67 in different clinicopathological features,level Ⅰ andⅡ lymph nodes（LNs） in breast cancer,and explore their clinical significance.Methods： The quantity and property of Ki67 expression in 42 primary invasive breast ductal cancers were detected using immunohistochemistry,which was compared with the LNs metastasis number and location,short axis of LNs detected by MRI and related clinicopathological features.Results： The positively involved rates in levels Ⅰ and Ⅱ LNs were 74.07% and 13.33%,respectively.The quanlitative analysis demonstrated that the expression difference of Ki67 in different short axis of LNs was statistically significant（ P 〈0.01）.The quanlitative analysis showed the expression level in metastasis LNs（46.19±5.40）was significantly higher than that in non-metastasis LNs（31.19±4.79）,the expression level of Ki67 in LNs with short axis≥0.7 cm（43.33±4.60） was significantly higher than that in LNs with short axis 〈0.7 cm（19.17±3.32） （ P 〈0.01）,and the positive expression of Ki67 in patients with age 〈45 and poorly differentiated tumor（WHOⅢ） were higher（ P 〈0.01）.The Ki67 expression in WHO Ⅰ to Ⅱwere significantly related to the WHOⅢ（ r =0.722, P 〈0.01）.The Ki67 expression was not significantly related to the number of the level Ⅰ and Ⅱ LNs（ P 〉0.05）,was related to the metastasis and metastatic ratio in levelⅠ LNs（ r =0.453,0.458,respectively, P 〈0.01）,and was significantly related to the short axis of level Ⅰ LNs（ r = 0.689 , P 〈0.01）.Conclusions： The expression level of Ki67 in breast cancer can help to evaluate the histological grade of cancer tissue,level Ⅰ LNs short axis and metastatic involvement,which has important significance and application prospect in clinic.