三阴性乳腺癌患者Ki-67表达水平的影响因素及预后价值分析

Analysis of influencing factors and prognostic value of Ki-67 expression in triple negative breast cancer patients

目的分析在三阴性乳腺癌(TNBC)患者中Ki-67表达水平的影响因素及预后价值。方法用Envision法检测80例TNBC患者的Ki-67表达水平,计算Ki-67的中位数,并根据中位数将患者分为Ki-67低表达组和Ki-67高表达组,分析Ki-67表达水平的影响因素和两组患者无病生存(DFS)率。结果 Ki-67中位数为25%。Ki-67低表达(≤25%)组占52. 5%(42/80),Ki-67高表达(> 25%)组占47. 5%(38/80)。两组组织学分级、肿瘤大小、淋巴结状态差异有统计学意义(P <0. 05)。多因素分析结果显示,组织学分级Ⅲ级、原发肿瘤T2～3是TNBC Ki-67高表达的独立危险因素(P <0. 05)。Kaplan-Meier分析显示,Ki-67低表达组3年DFS率[83. 3%(35/42)]高于Ki-67高表达组[68. 4%(26/38)],差异有统计学意义(P=0. 012)。结论组织学分级Ⅲ级、原发肿瘤T2～3是TNBC Ki-67高表达的独立危险因素,且Ki-67高表达患者预后较差。

Objective To analyze the influencing factors and prognostic value of Ki-67 expression in patients with triple negative breast cancer(TNBC).Methods Envision was used to detect the expression level of Ki-67 in 80 patients with TNBC.The median of Ki-67 was calculated,and the patients were divided into Ki-67 low expression and Ki-67 high expression group according to the median.Factors affecting Ki-67 expression levels and disease-free survival(DFS)rates in two groups were analyzed.Results The median Ki-67 was 25%.Ki-67 low expression(≤25%)group accounted for 52.5%(42/80),and Ki-67 high expression(>25%)group accounted for 47.5%(38/80).There were significant differences in histological grade,tumor size and lymph node status between two groups(P<0.05).Multivariate analysis showed that the histological gradeⅢand primary tumor T 2~3 were the independent risk factors for high expression of TNBC Ki-67(P<0.05).Kaplan-Meier analysis showed that the three-year DFS rate in Ki-67 low expression group was 83.3%(35/42),which was higher than that of Ki-67 high expression group whose three-year DFS rate was 68.4%(26/38),and the difference was statistically significant(P=0.012).Conclusion Histological gradeⅢ,primary tumor T 2~3 are the independent risk factors for high expression of TNBC Ki-67,and patients with high Ki-67 expression have a poor prognosis.