Ki-67、P53在脑膜瘤组织中的表达及其与复发的关系

The Correlation between Recurrence and the Expression of Ki-67 and P53 in Meningiomas

大部分脑膜瘤是良性的,尽管施行了手术全切除(Simpson’s Grade I),但是在原部位仍有一定的复发。本文通过检测Ki-67、P53在脑膜瘤中的表达,进一步研究其与肿瘤的良、恶性及肿瘤复发的关系,从而更好地判断其生物学行为。方法:收集1996年～2001年在南通医学院附属医院神经外科行脑膜瘤全切除手术治疗,并经9～84个月随访的60例患者的临床资料,采用SP免疫组化法检测手术切除石蜡包埋的脑膜瘤组织中Ki-67、P53的表达,以显微镜下细胞核内出现棕色颗粒为阳性,计算二者的标记指数(Labeling Index,LI)。结合患者的临床资料进行肿瘤细胞中Ki-67、P53的LI的差异性统计学分析。结果:(1)Ki-67、P53在不同病理形态脑膜瘤中的表达具有显著性差异(P<0.05),恶性脑膜瘤、非典型性脑膜瘤中的表达明显高于良性脑膜瘤;(2)良性脑膜瘤中Ki-67的表达在复发组明显高于未复发组(P<0.05),而P53的表达在复发组与未复发组比较无统计学意义(P>0.05)。结论:(1)Ki-67、P53蛋白的表达与脑膜瘤的病理分型有一定的关系。(2)Ki-67的表达情况可用来判断良性脑膜瘤有无复发的可能,从而进一步来指导临床治疗。

BACKGROUND & OBJECTIVE: Most of meningiomas were benign. But in spite of Simp-son grade I surgical resection, it has been reported that a part of these cases recurred after initial operation. This study is to investigate the correlation between the conventional histopathology, recurrence rate and the protein expres-sion of Ki-67 and P53 in meningiomas. It would be a useful parameter to estimate the biological behavior of meningiomas. METHODS: Data of patients, in whom the meningiomas were totally resected (Simpson's Grad-e I), were collected in our hospital between 1996 and 2001. The protein expression of Ki-67 and P53 in menin-giomas was examined by immunocytochemistry. Brown particles in cellular nucleus were considered as positive.The patient's clinical feature and the protein expression of Ki-67 and P53 were analyzed. RESULTS: The mean expression levels of Ki-67 and P53 in malignant and atypical meningiomas were significantly higher than in be-nign ones ( P<0.05) . Among benign meningiomas, there were a significant difference between the group with recurrence and the group without recurrence in the expression level of Ki-67 (P<0.05).CONCLUSION: There was a good correlation existing between histopathological grading,Ki-67 and P53 protein expression and clini-cal recurrence. In benign meningiomas, it's worth- while to include Ki-67 expression along with histopathological assessment. These markers could serve as predic-tors of future recurrence and guide clinical therapy.