Ki-67 Labeling Index Is a Predictor of Postoperative Persistent Disease and Cancer Growth and a Prognostic Indicator in Papillary Thyroid Carcinoma
Ki-67 Labeling Index Is a Predictor of Postoperative Persistent Disease and Cancer Growth and a Prognostic Indicator in Papillary Thyroid Carcinoma
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DOI：
10.1159/000347148
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发表时间：
2013-01-01
影响因子：
4.7
通讯作者：
Miya, Akihiro
中科院分区：
文献类型：
--
作者：
Miyauchi, Akira;Kudo, Takumi;Miya, Akihiro
背景资料：我们以前曾报道，Ki-67标记指数（LI）在原发性肿瘤和甲状腺球蛋白（Tg）的倍增时间（DT）是有效的甲状腺乳头状癌（PTC）患者的预后指标。目的：探讨这两个因素之间的关系。方法：收集1998年至2004年行甲状腺全切除术的PTC患者390例，计算Tg-DT。我们测定了原发性肿瘤中的Ki-67 LI，并将这些值与患者的临床病理因素、术后Tg状态、Tg-DT和预后进行比较。根据术后血清Tg值对Tg状态进行分类：生化持续性疾病（BPD）、可疑状态和生化缓解。结果：30例（8%）患者Ki-67阳性率为10%。Ki-67 LI与BPD显著相关（p < 0.0001）。BPD患者的比例随着Ki-67 LI类别的升高而增加：分别为24、67和87%。Ki-67 LI与Tg-DT呈显著负相关（斯皮尔曼rho =-0.5267，p < 0.0001）。378例无远处转移的患者中，68例复发，6例在随访期间（平均88个月）死于PTC。在多变量分析中，当从分析中排除Tg-DT和Tg状态时，Ki-67 LI仍然是无病生存期和疾病特异性生存期的独立预测因子。结论：Ki-67 LI在原发肿瘤中的评价可用于预测PTC患者术后Tg状态、Tg-DT和预后。版权所有（C）2013欧洲甲状腺协会由S. Karger AG，巴塞尔
Background: We previously reported that the Ki-67 labeling index (LI) in primary tumors and the thyroglobulin (Tg)-doubling time (DT) were potent prognostic indicators in patients with papillary thyroid carcinoma (PTC). Objectives: To elucidate the relationship between these two factors. Methods: A total of 390 patients with PTC who underwent total thyroidectomy between 1998 and 2004 and in whom the Tg-DT was calculated were enrolled. We determined the Ki-67 LI in primary tumors and compared these values with the patients' clinicopathological factors, postoperative Tg status, Tg-DT, and prognosis. Tg status was categorized by postoperative serum Tg values: biochemically persistent disease (BPD), equivocal state, and biochemical remission. Results: The Ki-67 LI was 10% in 30 patients (8%). Ki-67 LI was significantly associated with BPD (p < 0.0001). The proportion of BPD patients increased with the higher Ki-67 LI category: 24, 67, and 87%, respectively. The Ki-67 LI had a significant inverse correlation with the Tg-DT (Spearman's rho = -0.5267, p < 0.0001). Of the 378 patients without distant metastasis at surgery, 68 patients had recurrence, and 6 of the 390 patients died of PTC during the follow-up ( mean 88 months). On multivariate analyses, the Ki-67 LI remained an independent predictor of disease-free survival and disease-pecific survival when Tg-DT and Tg status were excluded from the analyses. Conclusions: Evaluation of the Ki-67 LI in primary tumors may allow the prediction of the postoperative Tg status, Tg-DT and prognosis of patients with PTC. Copyright (C) 2013 European Thyroid Association Published by S. Karger AG, Basel