α-SMA和Ki-67的表达及其与原发性腹膜后平滑肌肉瘤患者预后的关系  

Prognostic factors analysis of Ki-67, α-SMA expression in retroperitoneal leiomyosarcoma

作　　者：马超[1] 李沛雨[1] 张楠[1] 孙成博 侯雷[1] 刘娜[1] Ma Chao;Li Peiyu;Zhang Nan;Sun Chengbo;Hou Lei;Liu Na(Department of General Surgery, Chinese People＇s Liberation Army General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《中华肿瘤杂志》2018年第4期258-263,共6页Chinese Journal of Oncology

摘　　要：目的探讨α-SMA和Ki-67的表达及其与原发性腹膜后平滑肌肉瘤患者预后的关系。方法回顾性分析2002年5月至2015年12月解放军总医院收治的50例腹膜后平滑肌肉瘤患者的临床病理资料。男14例，女36例：年龄21-79岁，平均年龄48岁。单因素生存分析采用Kaplan．Meier法和Logrank检验，多因素生存分析采用Cox风险比例模型。结果50例患者中，完整切除45例，未完整切除5例。患者的生存时间为2-131个月，中位生存时间为35个月。患者的1、3、5年生存率分别为86．0％、46．0％和28．0％。单因素分析显示，肿瘤最大直径、手术切除程度、病理分级、α-SMA和Ki-67表达为患者预后的影响因素（均P〈0．05）。多因素分析显示，病理分级和手术切除程度为患者预后的独立影响因素（均P〈0．05）。结论腹膜后平滑肌肉瘤患者的预后较差，为达到肿瘤完整切除的目的，可根据术中情况联合周围器官切除。肿瘤过大、非完整切除、病理分级高、高表达Ki-67和α-SMA患者的预后差。Objective To investigate the expression and prognostic value of alpha smooth nmscle actin（α-SMA） and Ki-67 in retroperitoneal leiomyosarcoma. Methods Fifty retroperitoneal leiomyosarcoma patients who underwent operation in Chinese People＇s Liberation Army General Hospital from May 2002 to December 2015 were retrospectively analyzed. There were 14 males and 36 females form 21 to 79 and an average age of 48. Kaplan-Meier estimations and Cox regression analyses were performed. Results Of the 50 cases, 45 patients underwent complete resection, and others are not. The overall 1, 3, 5-year survival rates were 86.0%, 46.0% and 28.0%, respectively. Tumor size, extent of resection, pathological stage, and expression levels of Ki-67 and alpha smooth muscle actin （ et-SMA ） were closely related to the survival of retroperitoneal leiomyosarcoma patients （ all P 〈 0.05 ） , respectively. Multivariate analysis showed that pathological grade and degree of surgical resection were independent risk factors in the prognosis of patients （P〈O. 05 ）. Conclusion The high expression of α-SMA and Ki-67 are indicators of poor prognosis in retroperitoneal leiomyosarcoma, which can be used as a potential survival predictor in patients with retroDeritoneal leiomvosarcoma.

关 键 词：平滑肌肉瘤 腹膜后肿瘤 预后 肌动蛋白类 KI-67 Α-SMA 

分 类 号：R735.4[医药卫生—肿瘤]