Ki-67在肺鳞癌中的表达与化疗疗效及预后关系的分析
发布时间：2018-07-18 15:17
【摘要】：目的：化疗是治疗晚期肺鳞癌的重要手段之一,目前缺乏有效疗效的预测因子。通过分析Ki-67在肺鳞癌中的表达水平与化疗疗效及预后的关系,探讨Ki-67能否作为肺鳞癌的疗效预测因子和生存预后因子。方法：收集中国人民解放军总医院2007年1月—2014年12月收治的局部晚期或转移性肺鳞癌患者信息,共128例。将病理标本重新染色,判读Ki-67指数。根据Ki-67的表达分为阳性组和阴性组。对患者的临床特征、治疗情况和生存期等进行统计,并分析Ki-67的不同表达与化疗疗效和生存的关系。化疗疗效评价采用RECIST 1.1的标准。统计采用SPSS19.0软件进行。结果：128例患者,中位年龄58岁,Ⅲ期患者75例(58.6%),Ⅳ期患者53例(41.1%),高-中分化鳞癌为50例(39.1%),低分化为78例(60.9%)。一线接受吉西他滨联合铂类治疗的75例(58.6%),多西他赛联合铂类的42例(32.8%)。Ki-67的阳性表达为86例(67.2%),高表达的Ki-67指数与肺鳞癌较晚的临床分期和较差的病理分化有关。128例患者中,部分缓解(PR)患者为56例(43.8%),病情稳定(SD)为54例(42.2%),病情进展(PD)为18例(14%),客观缓解率(ORR)为43.8%。Ki-67的阳性表达组中,客观有效率为55.8%,Ki-67阴性组客观有效率为19.1%,P0.01。单因素分析中,Ki-67≥50%提示较差的无进展生存(3.8个月vs 5.7个月,P0.01)及总生存(12.1个月vs 20.1个月,P=0.005)。在多因素分析中,淋巴结转移和年龄≥60岁,提示较差的总生存;既往行放射治疗患者的预示着较好的总生存;Ki-67≥50%在预测无进展生存(HR 2.384,95%CI:1.556-3.653,P0.01)和总生存(HR 1.981,95%CI:1.181-3.322, P=0.01)中可以作为一个独立预后因素。结论：Ki-67的高表达与临床分期和病理分化程度有关。Ki-67的高表达与晚期肺鳞癌化疗敏感性相关。Ki-67的高表达是肺鳞无进展生存和总生存的独立预后因素。
[Abstract]:Objective: chemotherapy is one of the most important methods in the treatment of advanced lung squamous cell carcinoma. By analyzing the relationship between the expression of Ki-67 in lung squamous cell carcinoma and the curative effect and prognosis of chemotherapy, we discussed whether Ki-67 can be used as a prognostic factor and a prognostic factor of lung squamous cell carcinoma. Methods: 128 patients with locally advanced or metastatic squamous cell carcinoma of lung were collected from January 2007 to December 2014 in the General Hospital of the Chinese people's Liberation Army. The pathological specimens were re-stained and Ki-67 index was determined. According to the expression of Ki-67, it was divided into positive group and negative group. The clinical features, treatment status and survival time of the patients were statistically analyzed, and the relationship between Ki-67 expression and chemotherapeutic efficacy and survival was analyzed. The efficacy of chemotherapy was evaluated by RECIST 1.1 standard. SPSS 19.0 software was used for statistics. Results the median age of 128 cases was 58 years old, 75 cases (58.6%) of stage 鈪，
本文编号：2132314
[Abstract]:Objective: chemotherapy is one of the most important methods in the treatment of advanced lung squamous cell carcinoma. By analyzing the relationship between the expression of Ki-67 in lung squamous cell carcinoma and the curative effect and prognosis of chemotherapy, we discussed whether Ki-67 can be used as a prognostic factor and a prognostic factor of lung squamous cell carcinoma. Methods: 128 patients with locally advanced or metastatic squamous cell carcinoma of lung were collected from January 2007 to December 2014 in the General Hospital of the Chinese people's Liberation Army. The pathological specimens were re-stained and Ki-67 index was determined. According to the expression of Ki-67, it was divided into positive group and negative group. The clinical features, treatment status and survival time of the patients were statistically analyzed, and the relationship between Ki-67 expression and chemotherapeutic efficacy and survival was analyzed. The efficacy of chemotherapy was evaluated by RECIST 1.1 standard. SPSS 19.0 software was used for statistics. Results the median age of 128 cases was 58 years old, 75 cases (58.6%) of stage 鈪，
本文编号：2132314
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