Ki-67 proliferative index predicts progression-free survival of patients with well-differentiated ileal neuroendocrine tumors
Ki-67 proliferative index predicts progression-free survival of patients with well-differentiated ileal neuroendocrine tumors
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DOI：
10.1016/j.humpath.2011.06.011
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发表时间：
2012-04-01
期刊：
影响因子：
3.3
通讯作者：
Wolin, Edward
中科院分区：
文献类型：
--
作者：
Dhall, Deepti;Mertens, Richard;Wolin, Edward
Ki-67增殖指数（Ki-67 index）被认为是一个重要的预后变量，并被纳入神经内分泌肿瘤的分级参数之一。本研究旨在确定Ki-67指数和相应的肿瘤分级在预测回肠高分化神经内分泌肿瘤（wNETs）患者无进展生存期（PFS）中的有用性。研究了57例回肠wNETs患者的肿瘤。Ki-67的免疫组织化学染色进行的主要以及选定的转移性肿瘤和定量的计算机辅助图像分析，使用Ariol系统。根据核分裂活性和Ki-67指数对肿瘤进行分级。分析了影响PFS的临床和病理学变量。有29名女性和28名男性，平均年龄为59岁。在初次就诊时，8例患者（14%）有局限性疾病（1期和11期），29例患者（51%）有区域（淋巴结/肠系膜）扩散（111期），20例患者（35%）有远处转移（IV期）。12例患者在随后的随访期间发生疾病进展。初始IV期疾病患者更可能发生疾病进展（P = .005）。此外，较高的组织学分级（由Ki-67指数>2%确定）与PFS降低相关（P = .001）。在校正分析中考虑所有其他变量后，发现原发部位或转移部位Ki-67指数大于2%是PFS的唯一显著预测因素。总之，Ki-67指数可预测回肠wNET患者的PFS。(C)2012 Elsevier Inc. All rights reserved.
Ki-67 proliferative index (Ki-67 index) is suggested to be an important prognostic variable and is included as one of the grading parameters for neuroendocrine tumors. The present study was undertaken to determine the usefulness of the Ki-67 index and the corresponding tumor grade in predicting progression-free survival (PFS) of patients with ileal well-differentiated neuroendocrine tumors (wNETs). Tumors from 57 patients with ileal wNETs were studied. Immunohistochemical staining for Ki-67 was performed on the primary as well as selected metastatic tumors and quantitated by computer-assisted image analysis using the Ariol system. The tumors were graded based on mitotic activity and Ki-67 index. Clinical and pathological variables affecting the PFS were analyzed. There were 29 women and 28 men, with a mean age of 59 years. At the time of initial presentation, 8 patients (14%) had localized disease (stages 1 and 11), 29 patients (51%) had regional (nodal/mesenteric) spread (stage 111), and 20 patients (35%) had distant metastasis (stage IV). Twelve patients experienced disease progression during subsequent follow-up. Patients with initial stage IV disease were more likely to experience disease progression (P = .005). Additionally, higher histological grade (as determined by Ki-67 index >2%) was associated with a decreased PFS (P = .001). Ki-67 index greater than 2% at either the primary site or the metastatic site was found to be the only significant predictor of PFS after consideration of all other variables in an adjusted analysis. In conclusion, the Ki-67 index predicts PFS of patients with ileal wNETs. (C) 2012 Elsevier Inc. All rights reserved.