【摘要】：目的浸潤性小葉癌(invasive lobular carcinoma,ILC)組織中Ki-67表達的研究較少,對其預后預測價值尚需進一步文獻支持。本研究探討ILC組織不同臨床病理特征下Ki-67表達差異及其與預后的關(guān)系。方法收集天津醫(yī)科大學腫瘤醫(yī)院2003-01-10-2012-12-15收治的381例乳腺ILC患者的臨床病理資料,分析Ki-67與其臨床病理特征的相關(guān)性。分析不同年齡、月經(jīng)狀態(tài)、體質(zhì)量指數(shù)、家族史、腫瘤大小、淋巴結(jié)狀態(tài)、病理學分期、組織學分型、ER狀態(tài)、PR狀態(tài)、HER-2狀態(tài)和p53狀態(tài)下,Ki-67表達與預后的關(guān)系。結(jié)果 381例ILC組織中Ki-67低表達76例(19.9%),中表達91例(23.9%),高表達214例(56.2%)。在不同腫物大小(χ~2=12.524,P=0.014)、腋窩淋巴結(jié)情況(χ~2=6.114,P=0.047)、臨床分期(χ~2=10.434,P=0.034)、ER表達(χ~2=6.339,P=0.041)和組織學類型(χ~2=78.288,P0.001)情況下,Ki-67表達差異有統(tǒng)計學意義。Ki-67表達與腫物大小(r=0.168,P=0.001)、腋窩淋巴結(jié)情況(r=0.108,P=0.036)、臨床分期(r=0.149,P=0.004)和組織學類型(r=0.532,P0.001)呈正相關(guān)。Ki-67表達與ER表達呈負相關(guān),r=-0.112,P=0.029。在腫瘤大小2~5cm、有腋窩淋巴結(jié)轉(zhuǎn)移及臨床Ⅱ期ILC組織中,Ki-67表達對患者總生存(overall survival,OS)差異有統(tǒng)計學意義,P0.05;而對無病生存(disease-free survival,DFS)差異無統(tǒng)計學意義,P0.05。Cox多因素分析顯示,有無淋巴結(jié)轉(zhuǎn)移(P=0.000)是ILC總生存的獨立預后因素,而腫瘤大小、臨床分期和Ki-67表達水平不是影響ILC總生存的獨立預后因素,P0.05。結(jié)論乳腺ILC組織中Ki-67高表達。就診時腫物越大、有腋窩淋巴結(jié)轉(zhuǎn)移和臨床分期越高,Ki-67表達水平越高,而ER表達水平越高,Ki-67表達水平越低,腫物大小2~5cm、有腋窩淋巴結(jié)轉(zhuǎn)移及臨床Ⅱ期,即中低度惡性ILC組織中Ki-67表達對患者預后有一定的預測價值,但不是獨立預后因素,Ki-67對ILC預后預測作用尚需進一步研究。
[Abstract]:Objective to study the expression of Ki-67 in invasive lobular carcinoma (invasive lobular carcinoma,ILC) and its prognostic value need further literature support. The purpose of this study was to investigate the difference of Ki-67 expression in different clinicopathological features of ILC and its relationship with prognosis. Methods the clinicopathological data of 381 patients with breast ILC admitted in Cancer Hospital of Tianjin Medical University from January 10 to December 12, 2003 were collected and the correlation between Ki-67 and its clinicopathological features was analyzed. The relationship between the expression of Ki-67 and prognosis was analyzed under different age, menstrual state, body mass index, family history, tumor size, lymph node status, pathological stage, histological classification, ER status, PR state, HER-2 state and p53 status. Results there were 76 cases (19.9%) with low expression of Ki-67, 91 cases (23.9%) with moderate expression and 214 cases (56.2%) with high expression of Ki-67 in 381 cases of ILC. In different tumor sizes (蠂 ~ 2 ~ 2, 12.524), axillary lymph nodes (蠂 ~ 2 ~ 2, 6.114, P ~ (0.047), clinical stage (蠂 ~ 210.434), P ~ (0.034), ER expression (蠂 ~ (6.339) P ~ (0.041) and histological type (蠂 ~ (78.288), P ~ (0.041). Ki-67 expression and tumor size (rn 0.168 P0. 001), axillary lymph node status (rn 0. 108), clinical stage (rn 0. 149), P0. 001), Ki-67 expression and tumor size (0. 168% P0. 001), axillary lymph node status (0. 108% P0. 036), clinical stage (r = 0. 149, P < 0. The expression of Ki-67 was negatively correlated with the expression of ER. There was a significant difference in total survival (overall survival,OS) between patients with tumor size of 2 ~ 5 cm, axillary lymph node metastasis and clinical stage 鈪，

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