NSCLC患者Ki-67表达与EGFR19或21突变的关系及对预后的影响  

Relationship between Ki-67 expression with EGFR19 or 21 mutation in patients with NSCLC and its effect on prognosis

作　　者：刘谊[1] 张强[2] 王继忠[1] LIU Yi;ZHANG Qiang;WANG Jizhong(Department of Thoracic Surgery,Tianjin Municipal Children′s Hospital/Tianjin University Children′s Hospital,Tianjin 300070,China;Department of Pulmonary Oncology,Tumor Hospital of Tianjin Medical University,Tianjin 300060,China)

机构地区：[1]天津市儿童医院/天津大学儿童医院胸外科,300070 [2]天津医科大学肿瘤医院肺部肿瘤科,300060

出　　处：《重庆医学》2021年第8期1332-1337,共6页Chongqing medicine

基　　金：吴阶平医学基金会项目(320.6750.17245)。

摘　　要：目的探讨非小细胞肺癌(NSCLC)患者Ki-67表达与表皮生长因子受体(EGFR)19或21突变的关系及对预后的影响。方法选取天津市儿童医院和天津医科大学肿瘤医院100例NSCLC患者为研究对象,对NSCLC患者肿瘤组织样品进行Ki-67免疫组织化学染色及EGFR19或21突变检测。比较不同EGFR19或21突变类型NSCLC患者Ki-67表达差异,采用Cox回归分析探讨NSCLC患者预后的影响因素。结果Ki-67呈黄色或深棕黄色颗粒,定于细胞质;EGFR19或21野生型42例,其中Ki-67阳性36例;EGFR19或21突变型58例,其中Ki-67阳性24例;与野生组比较,突变组Ki-67蛋白表达阳性率明显降低(P<0.05)。EGFR19或21野生型、突变型与年龄相关性不明显(P>0.05);与淋巴血管间隙浸润、病理学分级、TNM分期、淋巴结转移、浸润深度、复发、肿瘤最大径相关,且有淋巴血管间隙浸润、病理学分期越高、TNM分期越高、有淋巴结转移、浸润深度越深、有复发、肿瘤最大径≥5 cm,EGFR19或21野生型比例越高(P<0.05)。EGFR19或21突变型NSCLC患者3年生存率及生存期均明显高于EGFR19或21野生型NSCLC患者(P<0.05)。TNM高分期、Ki-67阳性表达、EGFR19/21基因野生型是影响NSCLC患者预后的独立危险因素(P<0.05)。结论EGFR19或21野生型NSCLC患者Ki-67阳性率表达高,预后差;TNM高分期、Ki-67阳性表达、EGFR19/21基因野生型是影响NSCLC患者预后的独立危险因素。Objective To investigate the relationship between Ki-67 expression with EGFR19 or 21 mutation in the patients with non-small cell lung carcinoma(NSCLC)and its effect on prognosis.Methods One hundred patients with NSCLC in Tianjin Municipal Children′s Hospital and Tumor Hospital of Tianjin Medical University were selected as the research subjects.The Ki-67 immunohistochemical staining and EGFR19 or 21 mutation detection were performed on tumor tissue samples of NSCLC patients.The differences of expression of Ki-67 were compared among the patients with different EGFR19 or 21 mutation types of NSCLC.The Cox regression analysis was used to explore the influencing factors of prognosis in the patients with NSCLC.Results Ki-67 showed yellow or dark brownish yellow grains,and located in the cytoplasm.There were 42 cases of EGFR19 or 21 wild type,in which the Ki-67 positive was in 36 cases,58 cases were EGFR19 or 21 mutant type,in which the Ki-67 positive was in 24 cases.Compared with the wild type group,the positive rate of Ki-67 protein expression in the mutant group was significantly decreased(P<0.05).EGFR19 or 21 wild type and mutant type had no significant correlation with age(P>0.05);which had significant correlation with lymphovascular space infiltration,pathological grade,TNM stage,lymph node metastasis,recurrence,infiltration depth and maximum diameter of tumor,moreover the higher lymphovascular space infiltration,higher pathological stage,higher TNM stage,deeper lymph node metastasis,deeper infiltration,the higher the proportion of recurrence,tumor maximum diameter≥5 cm and EGFR19 or 21wild type(P<0.05).The 3-year survival rate and survival time of NSCLC patients with EGFR19 or 21 mutant type were significantly higher than those of the NSCLC patients with EGFR19 or 21 wild-type(P<0.05).High TNM stage,Ki-67 positive expression and EGFR19/21 gene wild type were the independent risk factors affecting the prognosis of NSCLC patients(P<0.05).Conclusion The expression of Ki-67 positive rate in NSCLC patients with

关 键 词：癌 非小细胞肺 KI-67表达 EGFR19 EGFR 21 突变 预后 

分 类 号：R734.2[医药卫生—肿瘤]