Ki-67抗原表达在良恶性嗜铬细胞瘤鉴别诊断中的意义  

The significance of Ki-67 antigen expression in the distinction between benign and malignant pheochromocytomas

作　　者：冯超[1] 李汉忠[1] 严维刚[1] 高健刚[1] 徐维峰[1] 罗玉凤[2] 曹金玲[2] 

机构地区：[1]中国医学科学院 中国协和医科大学 北京协和医院泌尿外科,100730 [2]中国医学科学院 中国协和医科大学 北京协和医院病理科,100730

出　　处：《中华外科杂志》2007年第24期1697-1700,共4页Chinese Journal of Surgery

摘　　要：目的研究 Ki-67抗原表达在良、恶性嗜铬细胞瘤鉴别诊断中的意义及其作为预测肿瘤生物学行为标志物的价值。方法采用免疫组织化学方法对57例临床确诊为良性(良性组,39例)或恶性(恶性组,18例)的嗜铬细胞瘤组织进行组织染色,检测 Ki-67抗原在嗜铬细胞瘤组织中的表达,并综合分析得出阳性指数。对两组数据进行统计学分析。结果良性及恶性组 Ki-67平均阳性指数分别为0.98%及3.78%,恶性组明显高于良性组。良性组中 Ki-67阳性指数>3%者占5.1%(2/39),恶性组中占55.6%(10/18),统计学分析两组数据差异具有统计学意义(P<0.05)。以 Ki-67阳性指数>3%为标准,对诊断恶性嗜铬细胞瘤的准确度为82.5%、灵敏度为55.6%、特异度为94.9%、阳性预测值为83.3%、阴性预测值为82.2%。随访结果显示,Ki-67高表达者术后生存率低于低表达者。结论 Ki-67抗原是检测肿瘤细胞增殖的良好标记,可用于鉴别良、恶性嗜铬细胞瘤,并对判断肿瘤的预后有着及其重要的意义。Ki-67阳性指数>3%具有区别良、恶性嗜铬细胞瘤及预测肿瘤生物学行为的意义。Objectives To investigate the expression of Ki-67 antigen in benign and malignant pheochromocytomas, and to evaluate whether the expression of Ki-67 antigen could serve as a diagnostic marker for predicting the biological behaviour of these tumors. Methods Ki-67 antigen were detected by immunohistochemical technique and image analysis in 57 cases of clinically documented benign and malignant pheoehromocytomas were analyzed. Aside from histological study, Ki-67 immunohistochemistry studies were performed to get the Ki-67 index. Statistical analysis was performed between these groups. Results Ki-67 index was low in benign pheochromocytomas （ average 0. 98% ）, and high in malignant pheochromocytomas （ average 3.78% ）. There was statistically significant difference in expressions of Ki-67 antigen between benign and malignant pheochromocytomas. The Ki-67 index of 2 cases in benign pheochromocytomas（5.1% , 2/39 ） and 10 cases in malignant pheochromocytomas （ 55.6%, 10/18 ） was higher than 3%. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Ki-67 index higher than 3% to diagnosis malignant pheochromocytomas was 82. 5% , 55.6%, 94, 9%, 83, 3% and 82, 2%. The follow-ups indicated the survival rate of patients with higher Ki-67 index was lower than those with lower Ki-67 index. Conclusions Ki-67 may serve as a useful marker of the biological behavior of tumors, and can provide useful information for prognosis of tumor patients. Immunohistochemical assessment of Ki-67 antigen can be useful in the differential diagnosis of malignant from benign pheochromocytomas. Ki-67 index （ 〉 3% ） is a useful marker for distinguishing benign from malignant tumors or for predicting the malignant potential of pheochromocytomas.

关 键 词：嗜铬细胞瘤 KI-67抗原 免疫组织化学 

分 类 号：R736.6[医药卫生—肿瘤]