Ki-67对腋窝淋巴结阳性的乳腺癌全乳腺切除术后的预后价值  

Prognostic value of Ki-67 in axillary lymph node-positive breast cancer after mastectomy

作　　者：戴明明[1] 吴三纲[1] 何振宇[2] 林勤[1] 李凤岩[2] 管迅行[2] 

机构地区：[1]厦门大学附属第一医院放疗科,福建厦门361000 [2]华南肿瘤学国家重点实验室,中山大学肿瘤防治中心放疗科,广东广州510060

出　　处：《现代肿瘤医学》2013年第7期1503-1507,共5页Journal of Modern Oncology

基　　金：广东省科技计划社会发展项目(编号:2008B060600019)

摘　　要：目的:探讨Ki-67对腋窝淋巴结阳性的乳腺癌全乳腺切除术后患者的预后价值。方法:回顾性分析2002年4月至2007年12月收治的可手术的腋窝淋巴结阳性乳腺癌患者454例。用Kaplan-Meier法计算生存率,Logrank法和Cox模型分别进行单因素和多因素预后分析。结果:Ki-67表达与病理分级、Her-2、p53的表达呈正相关,与ER、PR的表达呈负相关,与淋巴结转移状态、T分期等无相关性。对全组患者进行预后分析,未发现Ki-67对预后有影响。亚组分析发现对于腋窝淋巴结1-3个转移的患者,Ki-67为影响远处转移(P=0.006)和总体生存(P<0.001)的预后因素,多因素分析提示Ki-67为影响远处转移(P=0.011)和总体生存(P=0.003)的独立危险因素。而腋窝淋巴结≥4个转移的患者Ki-67则不影响预后(P均>0.05)。结论:Ki-67可做为腋窝淋巴结阳性乳腺癌患者的预后因素之一,特别是对于腋窝淋巴结1-3个转移的患者。Objective：To investigate the prognostic value of Ki-67 in axillary lymph node-positive breast cancer after mastectomy.Methods：For the retrospective data of 454 eligible patients between April 2002 to December 2007,survival analysis were performed using the Kaplan-Meier method.Univariate and multivariate analyses were performed using the Log-rank method and Cox regression.Results：High Ki-67 expression was positively significantly correlated with pathological grade,Her-2,p53 expression,and was negatively correlated with ER and PR（P all 0.05）.Not found high Ki-67 expression correlated with nodal involvement and larger tumor sizes.High Ki-67 expression was not impact the prognosis in entire cohort.In the subgroup analysis,patients with 1-3 positive lymph nodes,Ki-67 was an prognostic factor for metastasis-free survival（MFS）（P=0.006） and overall survival（OS）（P0.001） in univariate analysis,Ki-67 was not affect prognosis in patients with 4 or more positive lymph nodes（P0.05）.Multivariate analysis showed that for 1-3 positive lymph nodes,Ki-67 was an independent risk factor in MFS（P=0.011） and OS（P=0.003）.Conclusion：High Ki-67 expression indicates an unfavorable prognosis impact for MFS and OS in breast cancer patients with axillary lymph node-positive,especially for patients with 1-3 positive lymph nodes.

关 键 词：乳腺癌 KI-67 预后 全乳腺切除术 

分 类 号：R737.9[医药卫生—肿瘤]