Ki-67表达与原发性肝癌根治性切除术后行预防性肝动脉化疗栓塞患者预后的关系

Relationship between Ki-67 expression and prognosis of patients with primary liver cancer undergoing prophylactic transarterial chemoembolization after radical hepatectomy

目的:探讨Ki-67表达与原发性肝癌根治性切除术后行预防性TACE患者预后的关系。方法:采用回顾性队列研究,收集2014年12月-2016年1月福建医科大学孟超肝胆医院150例行原发性肝癌根治性切除术并在术后2个月内行预防性TACE患者的临床病理资料,根据术后肝癌组织病理Ki-67评分分为为低表达组(Ki-67评分≤20%,44例)和高表达组(Ki-67评分>20%,106例);分析Ki-67表达量与患者临床病理因素及复发与生存的关系。结果:高表达组肿瘤多发、肿瘤包膜不完整及合并微血管癌栓患者比例明显高于低表达组(均P<0.05)。Ki-67高表达与肿瘤多发、肿瘤直径大为影响无瘤生存期的独立危险因素(均P<0.05);Ki-67高表达与肿瘤多发、肿瘤直径大、肿瘤包膜不完整、合并微血管癌栓为影响总生存期的独立危险因素(均P<0.05);高表达组患者复发率明显高于低表达组(57.9%vs. 37.7%,χ^2=6.777,P<0.05),总生存率明显低于低表达组(45.6%vs. 75.9%,χ^2=8.447,P<0.05)。结论:Ki-67的表达量对肝癌根治性切除术后行预防性TACE患者的预后有显著影响,高表达者预后不良。

Objective: To investigate the association between the Ki-67 expression and the prognosis of patients with primary liver cancer receiving prophylactic transarterial chemoembolization(TACE) after radical resection. Methods: Using a retrospective cohort method, a total of 150 patients with primary liver cancer udergoing prophylactic TACE within 2 months after radical resection in Mengchao Hepatobiliary Hospital of Fujian Medical University from December 2014 to January 2016 were enrolled. According to postoperative pathological score of Ki-67 in the tumor tissue, the patients were divided into low Ki-67 expression group(Ki-67 score ≤20%, 44 cases) and high Ki-67 expression group(Ki-67 score >20%, 106 cases). The relations of Ki-67 expression level with the clinicopathologic factors as well as recurrence and survival of the patients were analyzed.Results: The proportions of patients with multiple lesions, incomplete capsule and concomitant microvascular tumor thrombus were significantly higher in high Ki-67 expression group than those in low Ki-67 expression group(all P<0.05). High Ki-67 expression along with multiple lesions and large tumor size were independent risk factors for disease-free survival of the patients(all P<0.05);high Ki-67 expression together with multiple lesions, large tumor size, incomplete tumor capsule and presence of microvascular tumor thrombus were independent risk factors for overall survival of the patients(all P<0.05). The recurrence rate was significantly higher(57.9% vs. 37.7%,χ^2=6.777, P<0.05) and the overall survival rate was significantly lower(45.6% vs. 75.9%,χ^2=8.447, P<0.05) in patients in high Ki-67 expression group than those in patients in low Ki-67 expression group.Conclusion: The Ki-67 expression level exerts significant impact on the prognosis of patients with primary liver cancer undergoing prophylactic TACE after radical resection. Those with high Ki-67 expression may have an unfavorable prognosis.