Ki-67与Cyfra21-1联合检测在鼻咽癌不良预后评估中的作用  

Clinical significance of Ki-67 and Cyfra21-1 in prediction of poor prognosis of nasopharyngeal carcinoma

作　　者：雷琳[1] 肖何[1] 陈川[1] 张志敏[1] 毛必静[1] 何轩[1] 谢飞[1] 丁琛琛 张辉[1] 杨镇洲[1] 王东[1] 王阁[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肿瘤中心,重庆400042

出　　处：《第三军医大学学报》2014年第11期1199-1202,共4页Journal of Third Military Medical University

摘　　要：目的探讨检测鼻咽癌组织Ki-67的表达水平及治疗后血清细胞角蛋白19片段21-1(Cyfra21-1)、鳞状细胞癌抗原(SCCA)、乳酸脱氢酶(LDH)、碱性磷酸酶(ALP)的含量在鼻咽癌不良预后评估中的作用及临床意义。方法回顾性分析2008年6-12月经病理确诊并接受根治性同步放化疗治疗的鼻咽鳞癌患者89例。免疫组化法检测患者鼻咽癌组织Ki-67表达情况,化学发光法检测治疗后血清Cyfra21-1、SCCA含量,连续监测法检测患者治疗后血清中的LDH、ALP含量。结果至2013年12月随访日结束,36例患者入组复发组,34例患者入组远处转移组,19例患者入组临床缓解组。临床缓解组患者鼻咽癌组织中的Ki-67表达水平低于远处转移组(P<0.05),且血清Cyfra21-1表达水平低于复发组及远处转移组(P<0.05)。同时,复发组患者的血清LDH表达水平低于远处转移组(P<0.05);血清ALP与SCCA在各组间未见明显差异(P>0.05)。Cox回归分析结果显示,组织Ki-67高表达(P<0.01,HR=1.973)与血清Cyfra21-1高表达(P<0.01,HR=1.537)均为无进展生存期的不良预后因素,血清Cyfra21-1高表达(P<0.01,HR=1.492)为总生存期的不良预后因素。通过建立预后指数方程发现,高危组与低危组患者的无进展生存期和总生存期差异有统计学意义(P<0.01)。结论联合检测患者鼻咽癌组织中Ki-67的表达水平与血清Cyfra21-1的含量可用于评估鼻咽癌患者的不良预后情况。Objective To estimate the clinical significance of tissue expression of Ki-67 and serum levels of cytokeratin 19 fragment Cyfra21-1, squamous cell carcinoma antigen （SCCA）, lactate dehydrogenase （LDH） and alkaline phosphatase （ALP） in the prognosis prediction of nasopharyngeal carcinoma. Methods A total of 89 patients with pathologically diagnosed nasopharyngeal carcinoma who receiving concurrent radiotherapy and chemotherapy in our center from June to December 2008 were recruited in this retrospective study. The expression of Ki-67 in the cancer tissue was detected by immunohistochemical assay, while the serum levels of Cyfra21-1, SCCA, LDH and ALP were measured by chemiluminescence assay and continuous monitoring after the treatment respectively. Results Till the end of follow-up （December 2013）, 36 cases were enrolled in recurrence group, while 34 cases and 19 cases were enrolled in distant metastasis group and clinical remission group respectively. The clinical remission group had obviously milder expression level of Ki-67 than the distant metastasis group （P=0.011）, and significantly lower level of Cyfra21-1 than the recurrence group and the distant metastasis group respectively （P〈0.05）. The LDH level was markedly lower in the recurrence group than the distant metastasis group （P〈0.05）. There was no significant difference in the levels of ALP and SCCA among the 3 groups （P〉0.05）. Cox regression analysis demonstrated that high expression of Ki-67 （P〈0.01, HR=1.973） and high serum level of Cyfra21-1 （P〈0.01, HR=1.537） were adverse prognostic factors for progression-free survival, and Cyfra21-1（P〈0.01,HR=1.492） was also an adverse prognostic factor for overall survival. Kaplan-Meier survival curves indicated that there were significant differences in progression-free survival and overall survival between the low risk and the high risk groups （P〈0.01）. Conclusion Combining detection of histological Ki-67 and serum Cyfra21-1 is of great valu

关 键 词：鼻咽癌 KI-67 细胞角蛋白19 CYFRA21-1 标志物 

分 类 号：R73-37[医药卫生—肿瘤] R730.43[医药卫生—临床医学]