局限期小细胞肺癌增强CT与Ki-67抗原表达的对照研究  

Contrast-enhanced CT and Ki-67antigen expression in limited-stage small cell lung cancer

作　　者：张荣荣[1,2] 李文武[2] 左文述[3] 徐亮[2] 黄勇[2] 张建波[4] 王海鹏[1,5] 

机构地区：[1]济南大学.山东省医学科学院医学与生命科学学院,山东济南250007 [2]山东大学附属山东省肿瘤医院放射科,山东济南250117 [3]山东大学附属山东省肿瘤医院外二科,山东济南250117 [4]山东大学附属山东省肿瘤医院病理科,山东济南250117 [5]山东大学附属山东省肿瘤医院外四科,山东济南250117

出　　处：《中华肿瘤防治杂志》2016年第6期373-377,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的局限期小细胞肺癌（limited—stage small cell lung cancer，LS—SCLC）是指SCLC局限于同侧胸腔、纵隔和锁骨上，无明显的上腔静脉压迫、声带麻痹及胸腔积液。Ki-67抗原可反映肿瘤细胞的增殖活性，间接提示肿瘤恶性程度。本研究旨在探讨LS—SCLC增强CT与Ki-67抗原表达水平的关系。方法回顾性分析山东大学附属山东省肿瘤医院2014—07—01—2015-09—01经穿刺活检或手术病理确诊的43例LS-SCLC患者的临床资料。患者均于穿刺活检或手术前行平扫及增强CT检查。穿刺或手术标本作免疫组化Ki-67抗原染色，测定肿瘤细胞阳性百分率，即Ki-67标记指数（Ki-67 labeling index，Ki-67LI）。分析CT征象、平扫及增强后CT值与Ki-67LI值的关系。结果43例LS-SCLC患者的Ki-67LI值为40％～90％，均值为（67．86±16．83）％。其瘤体最大径≥30mm、边缘清楚和无毛刺征Ki-67LI比瘤体最大径〈30mm、边缘毛糙和有毛刺征高，P值分别为0．002、0．033和0．023。平扫、Ⅰ和Ⅱ期增强后cT值与Ki-67LI值呈显著正相关性，P值分别〈0．001、0．003和0．038。K767LI值在有无坏死、空气支气管征、分叶征和淋巴结转移间差异无统计学意义，P〉0．05。结论LS-SCLC的增强CT与Ki-67抗原表达水平相关，可间接反应肿瘤的增殖活性，评估恶性程度。OBJECTIVE The limited-stage small cell lung cancer means the SCLC limited in the chest, mediastinum and supraclavicular on the same side, without superior vena cava, vocal cord paralysis and hydrothorax. Ki-67 antigen could reflect the proliferation of tumor, and it can be used to assess tumor malignant degree indirectly. The aim of this study was to explore the relationship between CT findings and Ki-67 antigen expression level of limited-stage small cell lung cancer. METHODS Contrast-enhanced CT scan of 43 cases of limited-stage small cell lung cancer before biopsy or operation were retrospectively reviewed during 2014-07-01--2015-09-01 in Shandong Cancer Hospital. All patients underwent contrast-enhanced CT scan before biopsy or operation. Ki-67 antigen staining was performed, and the positive per centage of tumor cells, namely, Ki-67 labeling index （Ki-67 LI）was recorded. Relationship of CT findings and Ki-67 LI values were analyzed. RESULTS The Ki-67 LI values in 43 cases of limited-stage small cell lung cancer were 40% to 90%, the mean value was （67.86± 16.83） %. The tumor maximum diameter was equal to or large than 30mm with well- defined margin and speculation prompt the high value of Ki-67 LI （P values were 0. 002, 0. 033 and 0. 023）. The attenuation of tumor at plain and 2 phase contrast-enhanced CT scan were closely related with Ki-67 LI values （P values were 0. 001, 0. 003 and 0. 038）. While, no significant difference of Ki-67 LI values was found between groups of whether with necrosis, air-filled bronchi, lobulation and lymph node metastasis or without. CONCLUSION The signs and values on contrast-enhanced CT scan are associated with Ki-67 LI, which indirectly reflect the proliferation of limited-stage small cell lung cancer, and it can be used in assessing tumor malignant degree.

关 键 词：局限期小细胞肺癌 增强CT KI-67抗原 肺神经内分泌肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]