Ki-67对意外胆囊癌术后患者预后判断的价值

The Clinical Significance of Ki-67 in Judging the Postoperative Prognosis of Patients with Unexpected Gallbladder Cancer

目的:探讨Ki-67对意外胆囊癌(UGC)术后患者预后判断的临床意义。方法:41例UGC患者,收集胆囊癌的病理分期(TNM分期)、手术方式、胆囊癌组织标本中Ki-67表达水平、术后随访UGC患者的生存时间,对TNM分期、手术方式、胆囊癌组织标本中Ki-67表达水平与UGC患者的生存时间进行单因素分析及Logistic回归分析。结果:随访1~158月的41例UGC患者中,术后存活1年以上共计29例(29/41,70.73%),3年以上共计18例(18/41,43.90%),5年以上存活8例(8/41,19.5%);单因素分析显示,UGC患者的1年和3年生存与肿瘤分期和手术方式显著相关,5年生存与肿瘤分期、手术方式和Ki-67显著相关;Logistic回归分析显示,手术方式和肿瘤分期与1年生存显著相关,肿瘤分期和3年生存呈显著负相关,肿瘤分期和Ki-67与5年生存呈显著负相关。结论:UGC患者胆囊切除标本中Ki-67表达越低,术后的5年生存率越高,Ki-67表达水平对UGC术后患者的预后判断有重要意义。

Objective:To investigate the clinical significance of Ki-67 in judging the postoperative prognosis of patients with unexpected gallbladder cancer(UGC).Methods:Forty one UGC patients were recruited in this study.TNM staging,surgical methods,the Ki-67 expression level in gallbladder cancer tissue specimens and the patient survival time during postoperative follow-up were collected.The association of the TNM staging,operation methods and the Ki-67 expression level with the survival time of UGC patients were analyzed by univariate analysis and Logistic regression analysis.Results:Among the 41 patients,followed up from 1 to 158 months after operation,29 survived over 1 year(29/41,70.73%),18 survived for more than 3 years(18/41,43.90%),8 survived for more than 5 years(8/41,19.5%).Univariate analysis showed that both the 1-year and 3-year survival rates were significantly correlated with the TNM staging and operation methods.And the 5-year survival rate was significantly correlated with the TNM staging,operation methods and Ki-67 expression level.The Logistic regression analysis showed that the 1 year survival rate was significantly correlated with the TNM staging and operation methods,but the 3-year survival rate was significantly,negatively correlated with the TNM staging.In addition,the 5-year survival rate was significantly,negatively correlated with the TNM staging and Ki-67 expression level.Conclusion:The lower the expression level of Ki-67 in the cholecystectomy specimens of UGC patients,the higher the 5-year survival rate after surgery.The expression level of Ki-67 is of great significance to the prognosis of UGC patients.