Ki-67水平对乳腺癌骨转移患者预后的影响

The influence of Ki-67 level on prognosis of breast cancer patients with bone metastasis

目的探讨Ki-67水平对乳腺癌骨转移患者预后的影响。方法回顾性分析2009年6月至2015年6月郑州大学第一附属医院收治的347例乳腺癌骨转移患者的临床资料,包括确诊乳腺癌骨转移时的年龄、原发肿瘤大小、组织学分级、有无其他部位转移、Ki-67、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER2)、骨转移前无进展生存期(PFS)、骨转移后无进展生存期(BM-PFS)和骨转移后总生存期(BM-OS)等。利用统计学软件分析相关指标与预后的关系。结果 Ki-67水平与骨转移前PFS有关(P<0.05)。Ki-67(-)组BM-PFS分别与Ki-67(+)组、Ki-67(++)组比较,差异无统计学意义(P>0.05)。Ki-67(++)组BM-PFS较Ki-67(+)组短, Ki-67(+++)组BM-PFS较Ki-67(-)组、Ki-67(+)组、Ki-67(++)组短,差异有统计学意义(均P<0.05)。Ki-67低表达组BM-OS较Ki-67高表达组长,差异有统计学意义(P<0.05)。PR阴性、PFS≤2 a、存在其他转移、多发骨转移是影响乳腺癌骨转移患者BM-OS的独立危险因素(P<0.05)。结论 Ki-67高表达的乳腺癌患者易较早发生骨转移,骨转移后疾病控制效果较差。Ki-67高表达的乳腺癌患者BM-OS较短。PR阴性、PFS≤2 a、多发骨转移、伴有其他转移是乳腺癌骨转移患者预后不良的独立危险因素。

Objective To investigate the influence of Ki-67 level on prognosis of breast cancer patients with bone metastasis.Methods The clinical data of 347 breast cancer patients with bone metastasis admitted to the First Affiliated Hospital of Zhengzhou University from June 2009 to June 2015 were retrospectively analyzed,including age at diagnosis of breast cancer with bone metastases,primary tumor size,histological grade,presence or absence of other site metastases,Ki-67,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER2),progression-free survival before bone metastasis(PFS),bone metastasis-progress free survival(BM-PFS)and bone metastasis-overall survival(BM-OS).Statistical software was used to analyze the relationship between relevant indicators and prognosis.Results The level of Ki-67 was related to PFS before bone metastasis(P<0.05).The BM-PFS of Ki-67(-)group was not significantly different from that of Ki-67(+)group and Ki-67(++)group(P>0.05).BM-PFS in Ki-67(++)group was shorter than that in Ki-67(+),and BM-PFS in Ki-67(+++)group was shorter than that in Ki-67(-)group and Ki-67(+)group and Ki-67(++)group,with statistically significant differences(P<0.05).The BM-OS in Ki-67 low expression group was higher than that in Ki-67 high expression group,and the difference was statistically significant(P<0.05).PR-negative,PFS≤2 a,other metastases and multiple bone metastases were independent risk factors for BM-OS in breast cancer patients with bone metastasis(P<0.05).Conclusion Breast cancer patients with higher expression level of Ki-67 are prone to bone metastasis earlier,and control effect for the disease is poor after bone metastasis.BM-OS is shorter in breast cancer patients with high Ki-67 expression.PR-negative,PFS≤2 a,multiple bone metastases and other metastases are independent risk factors for poor prognosis of breast cancer patients with bone metastases.