【摘要】 目的 探讨Ki-67抗原在幕上星形细胞肿瘤中的表达及其预后作用。方法 使用S-P免疫组化方法检测82例原发性幕上星形细胞肿瘤标本中Ki-67抗原的表达。单因素使用Kaplan-Meier法,多因素分析使用COX比例风险模型进行预后分析。结果Ki-67 指数在组织学分级GradeⅡ、Ⅲ、Ⅳ中分别为2.86%±1.57%,6.72%±3.95%,8.16%±3.92%(P<0.01)。单因素及多因素分析均提示Ki-67指数是独立的预后因素。在GradeⅡ中,Ki-67指数>2.5%与Grade Ⅲ中Ki-67指数≤2.5%的患者生存期差异无显著性(P>0.05);在GradeⅣ中,Ki-67指数≤2.5%与>2.5%的患者生存期有显著性差异(P<0.01)。结论 Ki-67指数随着各病理级别增高而增高;Ki-67指数>2.5%提示预后较差。在同一病理级别中,Ki-67指数不同,其预后有显著性差异。而部分不同病理级别的患者,随着Ki-67指数的不同,其生存期却无显著差异。联合组织病理检查及Ki-67指数检测有助于更精确地判断预后。更多还原

【Abstract】 Objective To determine the values of Ki-67 labeling indices (LI) in patients with supratentorial astrocytomas in order to understand their effect on patient’ s prognosis. Methods Ki-67 was determined with immunohistochemistry using monoclonal antibody MIB-1 in 82 patients with supratentorial astrocytic tumor. The univariate analysis based on Kaplan-Meier method estimated survival probabilities and Logrank test was used to assess the association between patient’ s prognosis and each variable. Meanwhile, multivariate regression analysis based on Cox proportional hazards model was applied to ascertain a simultaneous effect of outcome-related variables on prognosis. Results The mean Ki-67 LIs were 2.86% ± 1.57% in Grade Ⅱ, 6.72% ±3.95% in Grade Ⅲ, and 8.16% ±3.92% in Grade Ⅳ(P<0.01).Grade Ⅱ tumors with Ki-67 LI>5% had no significantly different mean survival periods compared with Grade Ⅲ tumors with Ki-67 LI≤2.5%. Grade Ⅳ tumors with Ki-67 LI>2.5% had significantly different mean survival periods compared with those with Ki-67 LI≤2.5%. Conclusion There is a strong positive relationship between Ki-67 LI and histologic grade. The higher histologic grade, the higher Ki-67 LI. Ki-67 LI>2.5% is a significant factor for shorter survival. In the same histologic grade, there is a significant difference in patient’s prognosis due to the different Ki-67 LI. Whereas, with the different Ki-67 LI, some patients with different histologic grades have no significant survival time. Ki-67 LI and histologic grade detected together will provide more accurate useful information for determining the patient’s prognosis.更多还原