High Ki67 Expression has Prognostic Value in Surgically-Resected T3 Gastric Adenocarcinoma
High Ki67 Expression has Prognostic Value in Surgically-Resected T3 Gastric Adenocarcinoma
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DOI：
10.7754/clin.lab.2015.150610
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发表时间：
2016-01-01
影响因子：
0.7
通讯作者：
Huang, Qiaojia
中科院分区：
文献类型：
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作者：
Huang, Guoliang;Chen, Shaoquan;Huang, Qiaojia
背景：Ki-67在调节细胞增殖中起重要作用，在多种类型的肿瘤中具有预后价值；然而，Ki67在切除的T3胃腺癌中的表达与预后的关系尚未被研究。方法：对2003年7月至2009年12月在同一机构接受手术切除的693例T3胃腺癌患者进行回顾性分析。采用免疫组织化学方法(IHC)检测Ki67在肿瘤组织中的表达，采用卡方检验、Kaplan-Meier生存分析、对数等级检验、单因素和多因素分析等方法分析Ki67与预后的关系。结果：335/693例(48.34%)Ki67高表达(IHC评分和Gt；=3+)。Ki67表达与远处转移、5年中位无复发生存期(MRFST)和5年中位总生存期(MOST)显著相关。中位复发时间为20个月，总生存时间为28个月。Ki67高表达与MRFST较短(13个月比27个月，P<；0.001)和MOST(21个月比35个月，P<；0.001比1067低表达)相关。多因素分析显示，Ki67高表达是复发(p=0.001)和远处转移(p=0.003)和总生存率(p=5.33x10(-5))增加的独立预后因素。结论：在切除的T3GA中Ki67高表达是复发、远处转移和总生存不良预后的重要预后因素。Ki67可能是预测切除T3GA预后的有用生物标志物。
Background: Antigen KI-67 (Ki67) plays a critical role in regulation of cell proliferation and has prognostic value in several types of cancer; however, the relationship between Ki67 expression and prognosis in resected T3 gastric adenocarcinoma (GA) has not yet been investigated.Methods: Retrospective analysis of 693 patients with T3 GA who underwent surgical resection at a single institution between July 2003 and December 2009 was performed. Ki67 expression in tumor tissues was examined using immunohistochemistry (IHC); the associations between Ki67 and prognosis/survival outcomes were assessed using the Chi-square test, Kaplan-Meier survival analysis, log-rank test, and univariate and multivariate analysis.Results: High Ki67 expression (IHC score >= 3+) was observed in 335/693 (48.34%) of cases. Ki67 expression was significantly associated with distant metastasis, 5-year median recurrence-free survival time in months (MRFST), and 5-year median overall survival time in months (MOST). Median recurrence and overall survival were 20 and 28 months. High Ki67 expression was associated with shorter MRFST (13 vs. 27 months, p < 0.001) and MOST (21 vs. 35 months, p < 0.001 compared to low 1067 expression). Multivariate analysis demonstrated that high Ki67 expression was an independent prognostic factor for an increased risk of recurrence (p = 0.001) and distant metastasis (p = 0.003) and poorer overall survival (p = 5.33 x 10(-5)).Conclusions: High Ki67 expression was frequently observed in resected T3 GA and was a significant prognostic factor for poor outcome with respect to recurrence, distant metastasis and overall survival. Ki67 may represent a useful prognostic biomarker for resected T3 GA.