Ki-67在乳腺癌各亚型中的表达及意义  

The expression and significance of Ki-67 in different subtype of breast cancer

作　　者：朱伟良[1] 谈炎[2] 王旭芬[1] 程锦玲[1] 张磊[1] 方琦[1] 谈珂岚[1] 杨澜[1] 王磊[1] 

机构地区：[1]常州市第一人民医院乳腺外科,江苏常州213003 [2]常州市第一人民医院病理科,江苏常州213003

出　　处：《中国癌症杂志》2012年第5期347-351,共5页China Oncology

摘　　要：背景与目的:目前公认的指导乳腺癌治疗和预后预测的生物学指标有雌激素受体(estrogenreceptor,ER)、孕激素受体(progesterone,PR)和人表皮生长因子受体2(human epidermal growth factorreceptor-2,HER-2)。近年来Ki-67逐渐成为一个新的研究热点,众多研究提示,Ki-67很可能是继HER-2之后又一个重要的生物指标。本研究旨在分析Ki-67在不同亚型的乳腺癌中的表达及临床意义。方法:收集常州市第一人民医院乳腺外科2010年1月—12月收治的252例乳腺癌患者的临床病理资料,通过免疫组化(immunohistochemistry,IHC)方法测定手术后乳腺癌组织的ER、PR、HER-2和Ki-67的表达以区分不同的乳腺癌亚型。结果:Ki-67指数在不同年龄及不同淋巴结转移状态间差异无统计学意义(P>0.05)。肿瘤直径>2 cm的患者Ki-67指数显著高于直径≤2 cm的患者(P=0.001)。病理分期为Ⅰ、Ⅱ和Ⅲ期患者的Ki-67指数均显著高于病理分期为0期的患者(P<0.05),但是Ⅰ、Ⅱ和Ⅲ期患者间的Ki-67指数差异无统计学意义(P>0.05)。ER阴性、PR阴性、HER-2阳性的患者的Ki-67指数均显著高于其对应的ER阳性、PR阳性和HER-2阴性的患者(P<0.05)。Luminal B型、HER-2过表达型和三阴型的Ki-67指数均显著高于Luminal A型(P<0.001),而LuminalB型、HER-2过表达型和三阴型三者间的Ki-67指数差异无统计学意义(P>0.05)。结论:Ki-67结合其他生物指标对预测乳腺癌的预后有一定意义,值得和ER、PR和HER-2同时进行检测。Background and purpose： The established prognostic and predictive parameters of breast cancer were estrogen-receptor （ER）, progesterone-receptor （PR） and human epidermal growth factor receptor-2 （HER-2） status. The Ki-67 is now becoming a new research focus, and many researches showed that Ki-67 is an important biomarker after HER-2. This research aimed to study the expression and significance of Ki-67 in different subtypes of breast cancer. Methods： Clinical and pathological data of breast cancer patients, treated in Department of Breast Surgery, The First People＇s Hospital of Changzhou from Jan. 2010 to Dec. 2010, were collected and analyzed. Immunohistochemical method was used to detect the expression of ER, PR, HER-2 and Ki-67 of these patients. Results： There were no correlations between the expression of Ki-67 and age or node metastasis of breast cancer patients, although there were significant differences in different tumor size of patients （P=-0.001）. The expressions of Ki-67 in stage I, lI and llI patients were significantly higher than those in stage 0 patients, while there was no significant difference between the three mutually. The expressions of Ki-67 in ER negative patients were significantly higher than ER positive patients, and this trendency extended to PR negative and HER-2 positive patients （P〈0.05）. The expressions of Ki-67 in Luminal B subtype, HER-2 over-expression subtype and basal like subtype were significantly higher than in Luminal A subtype （P〈0.001）, but there was no significant difference between the three mutually. Conclusion： Ki-67 provides prognostic information combined with other biologic markers, and co-detection of Ki-67, ER, PR and HER-2 may be useful.

关 键 词：乳腺癌 临床病理特征 KI-67 雌激素受体 孕激素受体 人表皮生长因子受体2 

分 类 号：R737.9[医药卫生—肿瘤]