胰头癌患者尿激酶型纤溶酶原激活剂与增殖细胞核抗原Ki-67的相关性及其对预后的影响

Correlation Between Urokinase-type Plasminogen Activator and Proliferating Cell Nuclear Antigen Ki-67 in Patients with Pancreatic Head Carcinoma and Their Effects on Prognosis

目的探讨胰头癌患者尿激酶型纤溶酶原激活剂(uPA)与增殖细胞核抗原Ki-67的相关性及其对预后的影响。方法以2000年1月至2007年12月于新疆军区总医院(38例)及郑州大学附属洛阳中心医院(34例)接受胰头癌根治术的72例患者为研究对象。采用免疫组化法检测病理标本中uPA、Ki-67蛋白表达情况,分析二者相关性,采用生存分析研究其对患者预后的影响。结果 uPA与Ki-67的表达呈正相关(r=0.263,P=0.026)。uPA和Ki-67蛋白均与肿瘤组织分化程度、临床分期及淋巴结转移有关,Ki-67与肿瘤直径有关(均P<0.05)。Kaplan-Meier生存曲线显示,uPA(-)/Ki-67(-)组患者术后生存期长于其他组,差异有统计学意义(P<0.05)。单因素生存分析显示,uPA和Ki-67过表达、肿瘤组织分化程度、淋巴结是否转移、临床分期与患者预后密切相关(均P<0.05)。将以上指标纳入多因素Cox回归模型,结果显示肿瘤组织分化程度、临床分期、uPA及Ki-67过表达是胰头癌患者预后的独立影响因素。结论 uPA与Ki-67在胰头癌进展过程中是一对协同因素,二者的阳性表达是患者预后的独立危险因素。

Objective To investigate the correlation between urokinase-type plasminogen activator(uPA) and proliferating cell nuclear antigen Ki-67 in patients with pancreatic head carcinoma and their effects on prognosis.Methods Seventy-two patients who underwent radical pancreatic head carcinoma surgery in Xinjiang Military District General Hospital(38 cases) and Luoyang Central Hospital Affiliated to Zhengzhou University(34 cases) from January 2000 to December 2007 were selected as subjects. Immunohistochemical method was used to detect the expression of uPA and Ki-67 protein in pathological specimens, and the correlation between the two was analyzed. The survival analysis was used to study the effects of them on prognosis.Results uPA was positively correlated with Ki-67(r=0.263, P=0.026). Both uPA and Ki-67 proteins were related to tumor differentiation, clinical stage and lymph node metastasis, and Ki-67 was related to tumor diameter(all P<0.05). Kaplan-Meier survival curve showed that the survival time of patients in uPA(-)/Ki-67(-) group was longer than those in other groups, and the differences were statistically significant(all P<0.05). Univariate survival analysis showed that uPA and Ki-67 overexpression, tumor tissue differentiation, lymph node metastasis, and clinical stage were closely related to prognosis(all P<0.05). The above indicators were included in multivariate Cox regression model. The results showed that tumor differentiation, clinical stage, uPA and Ki-67 overexpression were independent factors affecting the prognosis.Conclusion uPA and Ki-67 are a pair of synergistic factors in the progression of pancreatic head carcinoma, and their positive expressions are independent risk factors for the prognosis.