Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort.
Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort.
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DOI：
10.1038/bjc.2012.598
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发表时间：
2013-02-05
影响因子：
8.8
通讯作者：
Berney, D. M.
中科院分区：
文献类型：
--
作者：
Fisher, G.;Yang, Z. H.;Kudahetti, S.;Moller, H.;Scardino, P.;Cuzick, J.;Berney, D. M.
标准临床参数无法准确区分惰性前列腺癌和侵袭性前列腺癌。我们之前的工作表明，免疫组织化学 (IHC) Ki-67 改善了通过经尿道前列腺电切术 (TURP) 诊断的保守治疗的临床局限性前列腺癌队列中前列腺癌死亡的预测。在这里，我们展示了更具临床相关性的针吸活检队列的结果。对活检标本进行微阵列分析。测量每个核心的 Ki-67 阳性染色恶性细胞的百分比，并使用 Cox 比例风险模型分析前列腺癌死亡时间中使用的每个个体的最大分数。在单变量分析 (n=293) 中，二分 Ki-67 (⩽10%, >10%) 的风险比 (HR)（95% 置信区间）为 3.42 (1.76, 6.62) χ2 (1 df)=9.8，P=0.002。在多变量分析中，Ki-67 在格里森评分和前列腺特异性抗原提供的基础上添加了显着的预测信息（HR=2.78（1.42，5.46），χ2（1 df）=7.0，P=0.008）。前列腺穿刺活检的 IHC Ki-67 评分是可行的，并产生了重要的预后信息。与之前的 TURP 队列相比，它的信息量较少，其中肿瘤样本更大、更全面，但在每个患者活检数量更多的更现代的队列中，Ki-67 可能被证明是更强大的生物标志物。
Standard clinical parameters cannot accurately differentiate indolent from aggressive prostate cancer. Our previous work showed that immunohistochemical (IHC) Ki-67 improved prediction of prostate cancer death in a cohort of conservatively treated clinically localised prostate cancers diagnosed by transurethral resection of the prostate (TURP). Here, we present results in a more clinically relevant needle biopsy cohort. Biopsy specimens were microarrayed. The percentage of Ki-67 positively stained malignant cells per core was measured and the maximum score per individual used in analysis of time to death from prostate cancer using a Cox proportional hazards model. In univariate analysis (n=293), the hazard ratio (HR) (95% confidence intervals) for dichotomous Ki-67 (⩽10%, >10%) was 3.42 (1.76, 6.62) χ2 (1 df)=9.8, P=0.002. In multivariate analysis, Ki-67 added significant predictive information to that provided by Gleason score and prostate-specific antigen (HR=2.78 (1.42, 5.46), χ2 (1 df)=7.0, P=0.008). The IHC Ki-67 scoring on prostate needle biopsies is practicable and yielded significant prognostic information. It was less informative than in the previous TURP cohort where tumour samples were larger and more comprehensive, but in more contemporary cohorts with larger numbers of biopsies per patient, Ki-67 may prove a more powerful biomarker.
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影响因子：
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作者：
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通讯作者：
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接受保守治疗的局限性前列腺癌男性的长期结果。
影响因子：
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作者：
Cuzick, J.;Fisher, G.;Kattan, M. W.;Berney, D.;Oliver, T.;Foster, C. S.;Moller, H.;Reuter, V.;Fearn, P.;Eastham, J.;Scardino, P.
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影响因子：
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