摘要
目的:探讨T细胞非霍奇金淋巴瘤(NHL)Ki-67表达及其临床意义。方法:回顾性分析天津医科大学附属肿瘤医院2000年1月～2007年12月。首诊初治T细胞NHL患者78例。治疗采用标准的CHOP、BACOP或CHOP-E方案,T、Ⅱ期患者联合放疗。记录每位患者治疗前的年龄、性别、病理类型、临床分期、ECOG评分、最大肿瘤直径、结外受累部位数、有无B症状、LDH水平、β2MC水平、国际预后指数(IPI)、治疗方案、治疗效果、无进展生存期(PFS)及总生存期(OS)。应用免疫组化方法检测Ki-67的表达情况。应用SPSS 16.0软件进行统计学分析,探讨Ki-67表达与各临床因素之间的关系。结果:Ki-67低表达32例,高表达46例。Ⅰ、Ⅱ期与Ⅲ、Ⅳ期患者之间,最大肿瘤直径≤5cm与>5cm患者之间,LDH水平正常与升高患者之间的Ki-67表达水平有统计学差异(P<0.05)。Ki-67表达水平与其它临床因素之间无统计学差异。Ki-67高表达患者的化疗有效率为78.3%,低表达患者为68.8%,两者之间无统计学差异(P=0.344)。Ki-67低表达患者的PFS及OS较高表达患者长,并且有统计学差异(分别为P=0.036和P=0.029)。多因素分析表明Ki-67是影响PFS及OS的独立预后因素。结论:Ki-67表达水平是T细胞NHL重要的预后因素,是对IPI的重要补充,两者相结合对预测患者的病情发展、制定个体化治疗策略有重要意义。
Objective： To analyze the expression and clinical significance of Ki-67 in T-cell non-Hodgkin lymphoma （NHL）. Methods： Data from 78 patients with untreated T-cell NHL seen in our hospital in the past 8 years were reviewed. All of the diagnoses were confirmed by at least two pathologists. Chemotherapy （CHOP or BACOP or CHOP-E） with standard dosage was administered to every patient. Patients with stage Ⅰ or Ⅱ disease received concurrent radiotherapy. Patient age, gender, pathological type, clinical staging, ECOG per-formance status, maximum diameter of tumor, number of tumor sites excluding lymphoid nodules, presence of B symptoms, LDH level, β2MG levl, international prognostic index （IPI）, method of treatment, response to chemotherapy, progression-free survival （PFS） and overall survival （OS） were recorded. The expression of Ki-67 was determined using immunohistochemistry. The relationship between the expression of Ki-67 and the clinical factors was analyzed using SPSS 16.0. Results： There were 32 patients with low expression of Ki-67 and 46 patients with high expression of Ki-67. The expression of Ki-67 was significantly different among patients of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ. The expression of Ki-67 in patients with a maximum tumor diameter less than or equal to 5cm was significantly different than the expression found in patients with a maximum tumor diameter greater than 5cm. A significant difference was found in Ki-67 expression between patients with a normal LDH level and those with an abnormal LDH level. The response rate to chemotherapy was 78.3% in patients with high Ki-67 expression and 68.8% in patients with low Ki-67 expression, with no significant difference detected between the two groups （P=0.344）. Patients with low Ki-67 expression had longer PFS （P=0.036） and OS （P=0.029） than patients with high Ki-67 expression. Multivariate analysis confirmed that Ki-67 was an independent prognostic factor related to PFS and OS. Conclusion： Ki-67 protein expression level is a very important prognostic factor for patients with T-cell NHL and is an important complement to IPI. The combination of these two factors is valuable for estimating disease progression and designing individual treatment strategies.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第11期644-647,共4页
Chinese Journal of Clinical Oncology
基金
教育部留学回国人员科研启动基金资助(编号:教外司留2008-101号)
