膀胱癌组织Ki-67、p53和CK-20的表达及与肿瘤病理特征和患者预后的关系  

Expressions of Ki-67,p53,and cytokeratin 20 in bladder cancer tissues:Correlation with tumor pathological characteristics and patient prognosis

作　　者：王梅利 杨玉成[1] 卞振华 何垚澍 陈敏婕 Wang Mei-li;Yang Yu-cheng;Bian Zhen-hua;He Yao-shu;Chen Min-jie(Department of Urology,Wuxi Traditional Chinese Medicine Hospital,Wuxi,Jiangsu 214071,China;Department of Pharmacy,Wuxi Traditional Chinese Medicine Hospital,Wuxi,Jiangsu 214071,China;Department of Pathology,Wuxi Traditional Chinese Medicine Hospital,Wuxi,Jiangsu 214071,China)

机构地区：[1]无锡市中医医院泌尿外科,江苏无锡214071 [2]无锡市中医医院药学部,江苏无锡214071 [3]无锡市中医医院病理科,江苏无锡214071

出　　处：《中国现代医学杂志》2025年第6期84-90,共7页China Journal of Modern Medicine

基　　金：江苏省中医药科技发展计划项目(No:MS2023066)。

摘　　要：目的分析膀胱癌组织Ki-67、p53和细胞角蛋白20(CK-20)的表达及与肿瘤特征及患者预后的关系。方法回顾性分析2018年1月—2021年2月无锡市中医医院接收的103例膀胱癌患者的临床资料。取患者肿瘤组织和癌旁组织,分别检测Ki-67、p53和CK-20的表达。比较肿瘤组织与癌旁组织Ki-67、p53、CK-20阳性表达情况,分析肿瘤组织Ki-67、p53、CK-20蛋白表达与临床病特征(病理类型、临床分期、肿瘤数目、肿瘤直径、淋巴结转移、浸润性)的关系。对所有患者进行为期3年的随访,根据患者是否肿瘤复发、转移、出现新病灶或死亡,将患者分为预后良好组(71例)和预后不良组(32例),比较两组患者肿瘤组织Ki-67、p53、CK-20表达情况,通过多因素一般Logistic回归模型分析蛋白表达与预后的关系。结果肿瘤组织Ki-67、p53、CK-20阳性表达率均高于癌旁组织(P<0.05)。T3、4分期、有淋巴结转移和浸润性患者肿瘤组织Ki-67、p53、CK-20阳性表达率更高(P<0.05)。预后不良组肿瘤组织Ki-67、p53、CK-20阳性表达率均高于预后良好组(P<0.05)。多因素一般Logistic回归分析结果显示:Ki-67高表达[OR=8.699(95%CI:2.253,33.591)]、p53高表达[OR=10.582(95%CI:2.175,51.492)]、CK-20高表达[OR=5.486(95%CI:1.375,21.885)]均是膀胱癌患者预后不良的危险因素(P<0.05)。受试者工作特征曲线结果显示,Ki-67、p53、CK-20联合预测膀胱癌患者预后不良的敏感性为75.0%(95%CI:0.566,0.885),特异性为77.5%(95%CI:0.660,0.865),曲线下面积为0.805(95%CI:0.720,0.890)。结论膀胱癌组织Ki-67、p53和CK-20的表达均会升高,且与患者预后密切相关。Objective To analyze the relationship between the expressions of Ki-67,p53,and cytokeratin 20(CK-20)in bladder cancer tissues and tumor characteristics as well as patient prognosis.Methods A retrospective analysis of clinical data from 103 bladder cancer patients admitted to our hospital from January 2018 to February 2021 was performed.The expressions of Ki-67,p53,and CK-20 were examined in tumor tissues and adjacent non-tumor tissues.The positive expression rates of Ki-67,p53,and CK-20 in tumor tissues versus adjacent tissues were compared,and the correlations between protein expressions in tumor tissues and clinicopathological features pathological pattern,clinical stage,number of tumors,tumor diameter,lymph node metastasis,invasiveness were analyzed.A three-year postoperative follow-up was conducted for all patients,who were classified into the good prognosis(n=71)and poor prognosis(n=32)groups based on whether they experienced tumor recurrence,metastasis,new lesions,or death.The expressions of Ki-67,p53,and CK-20 in these groups were compared,and multivariable Logistic regression analysis was used to determine the association between protein expressions and prognosis.Results The positive expression rates of Ki-67,p53,and CK-20 in tumor tissues were significantly higher than those in adjacent tissues(P<0.05).In patients with T3 and T4 stage tumors,lymph node metastasis,and invasive tumors,the positive expression rates of Ki-67,p53,and CK-20 in tumor tissues were even higher(P<0.05).In the poor prognosis group,the positive expression rates of Ki-67,p53,and CK-20 in tumor tissues were also higher than those in the good prognosis group(P<0.05).Multivariable Logistic regression analysis showed that high expressions of Ki-67[OR=8.699(95%CI:2.253,33.591)],p53[OR=10.582(95%CI:2.175,51.492)],and CK-20[OR=5.486(95%CI:1.375,21.885)]were independent risk factors for poor prognosis in bladder cancer patients(P<0.05).ROC curve analysis indicated that the sensitivity of combined detection of Ki-67,p53,and CK-20 was 75.0%(95

关 键 词：膀胱癌 细胞角蛋白20 KI-67 P53 病理特征 

分 类 号：R7373.14[医药卫生—肿瘤]