Effect of KI-67 positive cellular index on prognosis after hepatectomy in Barcelona Clinic Liver Cancer stage A and B hepatocellular carcinoma with microvascular invasion.
Effect of KI-67 positive cellular index on prognosis after hepatectomy in Barcelona Clinic Liver Cancer stage A and B hepatocellular carcinoma with microvascular invasion.
复制标题
KI-67阳性细胞指数对巴塞罗那临床肝癌A期和B期肝细胞癌伴微血管侵犯肝切除术后预后的影响。
DOI：
10.2147/ott.s165244
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发表时间：
2018
影响因子：
4
通讯作者：
Li LQ
中科院分区：
文献类型：
--
作者：
Li HH;Qi LN;Ma L;Chen ZS;Xiang BD;Li LQ
本研究旨在探讨KI-67阳性细胞指数与巴塞罗那临床肝癌（BCLC）A期和B期肝细胞癌（HCC）患者，特别是伴有微血管浸润（MVI）患者的无复发生存期（RFS）之间的关系。共333例接受根治性肝切除术的患者进行了KI-67阳性细胞指数的回顾性免疫组化分析。总的来说，41.1%（137/333）的HCC患者显示高KI-67阳性细胞指数（>35%）。KI-67阳性细胞指数高者RFS较低者差（P<0.0001）。然后将患者再分为MVI阳性组（n=192）和MVI阴性组（n=141）。在MVI阳性组中，KI-67阳性细胞指数高者术后RFS较低者短（P<0.0001）。而MVI阴性组中高、低指数亚组间RFS无显著性差异（P>0.05）。此外，与KI-67细胞指数水平无关，KI-67阳性细胞指数高且MVI阳性的患者的RFS在所有MVI阴性患者中最短（P<0.0001）。多因素分析显示，结节数>1、包膜缺失、KI-67阳性细胞指数高、甲胎蛋白>400 ng/mL是HCC伴MVI复发的独立危险因素。我们的研究结果表明，高KI-67阳性细胞指数可能代表BCLC A和B期HCC患者的不良预后因素，尤其是MVI患者。
This study aimed to explore the relationship between KI-67 positive cellular index and recurrence-free survival (RFS) in Barcelona Clinic Liver Cancer (BCLC) stage A and B hepatocellular carcinoma (HCC) patients, particularly those with microvascular invasion (MVI). A total of 333 patients who underwent curative hepatectomy had their immunohistochemistry analyzed retrospectively for KI-67 positive cellular index. In total, 41.1% (137/333) of HCC patients displayed high KI-67 positive cellular index (>35%). Patients with high KI-67 positive cellular index had poorer RFS than those with low index (P<0.0001). Patients were then subdivided into an MVI positivity group (n=192) and an MVI negativity group (n=141). In the MVI positivity group, patients with high KI-67 positive cellular index had a shorter RFS after operation as compared to those with low index (P<0.0001). However, there was no significant difference in RFS between high- and low-index subgroups within the MVI negativity group (P>0.05). Additionally, patients with high KI-67 positive cellular index combined with MVI positivity had the shortest RFS of all those with MVI negativity, regardless of KI-67 cellular index level (P<0.0001). Multivariate analysis showed that node number >1, capsule absence, high KI-67 positive cellular index, and alpha-fetoprotein >400 ng/mL were independent risk factors for a recurrence of HCC with MVI. Our results suggested that high KI-67 positive cellular index may represent a poor prognostic factor in BCLC stage A and B HCC patients, especially those with MVI.