Ki-67表达对儿童髓母细胞瘤预后的影响研究

Effect of Ki-67 expression on prognosis of pediatric medulloblastoma

目的分析髓母细胞瘤(medulloblastoma,MB)患儿的临床特征及生存情况,初步探讨Ki-67对MB患儿预后的影响。方法以2006年1月至2015年12月上海交通大学医学院附属新华医院小儿神经外科收治的67例术后病理证实为MB的患儿为研究对象,采用Kaplan-Meier法计算患儿5年生存时间(overall survival,OS)和无进展生存时间(progression free survival,PFS)。MB患儿预后相关因素的单因素分析采用Log-rank检验,多因素分析采用Cox回归。结果67例MB患儿Ki-67指数为(34.85±16.72)%,Ki-67低表达(<35%)组37例,5年PFS为70.27%(26/37)、OS为51.35%(19/37);Ki-67高表达(≥35%)组30例,5年PFS为40.00%(12/30),OS为36.67%(11/30);Cox比例风险回归模型显示:Ki-67高表达是儿童MB生存时间短的独立影响因素(P=0.04),但与术后转移、复发无关(P>0.05)。结论Ki-67指数可作为评估儿童MB预后的重要独立预测生物标志物。

Objective To explore the clinical characteristics and survival profiles of pediatric medulloblastoma and examine the effect of Ki-67 on its prognosis.Methods From January 2006 to December 2015,a total of 67 postoperatively pathologically confirmed MB children were recruited.Their 5-year overall survival(OS)and progression-free survival(PFS)were calculated by Kaplan-Meier method.Univariate analysis was performed by Log-rank test and multivariate analysis by Cox regression.The relationship was examined between clinical characteristics of MB,treatments and the expression of Ki-67 on the prognosis.Results The average Ki-67 index was(34.85±16.72%).There were 37 cases in low-expression of Ki-67 group(<35%),5-year PFS(70.27%,26/37)and OS(51.35%,19/37);30 cases in high-expression of Ki-67 group(≥35%),5-year PFS(40.00%,12/30)and OS(36.67%,11/30).Cox proportional risk regression model showed that a high expression of Ki-67 was an independent factor for MB survival in children(P=0.04).However,no statistically significant difference existed in postoperative metastasis or recurrence.Conclusion Ki-67 is an independent prognostic biomarker for pediatric MB.