Ki67 staining index and neuroendocrine differentiation aggravate adverse prognostic parameters in prostate cancer and are characterized by negligible inter-observer variability
Ki67 staining index and neuroendocrine differentiation aggravate adverse prognostic parameters in prostate cancer and are characterized by negligible inter-observer variability
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DOI：
10.1007/s00345-008-0257-0
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发表时间：
2008-06-01
影响因子：
3.4
通讯作者：
May, Matthias
中科院分区：
文献类型：
--
作者：
Gunia, Sven;Albrecht, Knut;May, Matthias
本研究旨在阐明通过Ki 67染色指数（Ki 67 SI）评估的神经内分泌分化（NED）和/或增殖活性是否可能加重常用于预测手术治疗前列腺癌结果的其他既定不良预后参数，并评估内部-观察者在分配NED和Ki 67 SI方面的变异性。材料和方法：共528例因前列腺癌手术治疗的患者，在这项研究中评估。通过病历回顾性获得相关数据。对存档的手术材料进行针对嗜铬粒蛋白A和Ki 67的抗体免疫染色，并由两名对标本不知情的独立组织病理学家进行评价。术后平均随访46.4个月，定期记录术后血清PSA水平以确定生化进展。通过考克斯回归风险回归方法进行多变量分析，以评估NED和/或Ki 67 SI对已确定的不良预后参数（淋巴结状态、肿瘤分期、治疗前PSA水平和Gleason评分）的可能加重。Ki 67 SI和NED被证明是显着加剧这些既定的不良预后参数，并被发现其特点是可以忽略不计的观察者之间的variability.Conclusion Ki 67 SI和NED应该提倡由组织病理学家呈现，因为这两个参数可以化学方法确定，而无需太多的额外费用，在时间和成本。这一概念的回报是在评估手术后个体风险状况时获得额外的预后准确性。
Introduction This study aims to clarify whether neuroendocrine differentiation (NED) and/or proliferation activity assessed by means of Ki67 staining index (Ki67SI) might aggravate other established adverse prognostic parameters commonly used for predicting outcome in surgically treated prostate cancer, and to assess inter-observer variability in assigning NED and Ki67 SI.Material and methods A total of 528 patients surgically treated due to prostate cancer were evaluated in this study. Relevant data were retrospectively obtained by chart review. Immunostaining with antibodies directed against Chromogranin A and Ki67 was performed on archived surgical material, and was evaluated by two independent histopathologists blinded to the specimens. Surveying a median postsurgical follow-up of 46.4 months, postsurgical serum PSA-levels were regularly documented for identifying biochemical progress. Multivariate analysis was performed by means of the Cox regression hazards regression method to evaluate possible aggravations of established adverse prognostic parameters (nodal status, tumour stage, pretherapeutic PSA-level, and Gleason score) by NED and/or Ki67SI. Ki67 SI and NED were shown to significantly aggravate these established adverse prognostic parameters, and were found to be characterized by negligible inter-observer variability.Conclusion Ki67 SI and NED should be advocated to be rendered by the histopathologist because both parameters can be immunohistochemically determined without much additional expense in time and cost involved. This concept is rewarded by an additional gain of prognostic accuracy in evaluating individual risk profile after surgery.