Ki-67在乳腺癌及腋窝转移淋巴结中的表达及临床应用  

The clinical application of Ki-67 expression in breast cancer and metastatic lymph nodes

作　　者：宋以宁 史明明[1] 陈文信 邵光东 金占杰 李璟 李国楼[1] 王晓琳[3] SONG Yining;SHI Mingming;CHEN Wenxin;SHAO Guangdong;JIN Zhanjie;LI Jing;LI Guolou;WANG Xiaolin(Department of Breast and Thyroid Surgery,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China;Department of Science and Education,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China;Department of Pathology,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]潍坊市中医院乳腺甲状腺外科,山东潍坊261041 [2]潍坊市中医院教学培训部,山东潍坊261041 [3]潍坊市中医院病理科,山东潍坊261041

出　　处：《山东第二医科大学学报》2024年第6期401-406,共6页Journal of Shandong Second Medical University

基　　金：潍坊市卫生健康委员会科研项目(项目编号:WFWSJK-2022-095)。

摘　　要：目的探讨免疫细胞化学逆染Ki-67蛋白在乳腺癌及转移淋巴结细胞中的表达及临床应用。方法选取潍坊市中医院2021年12月~2023年6月经影像学评估腋窝可疑转移的61例乳腺癌患者,行超声引导下乳腺肿物细针穿刺活检+原发肿物粗针穿刺活检+影像学评估可疑淋巴结的细针穿刺活检术;评估细针穿刺同粗针穿刺的差异;对穿刺腋窝淋巴结证实转移后45例患者行免疫细胞化学逆染Ki-67染色,进行二次分析。结果61例患者乳腺癌细针穿刺与粗针穿刺比较,诊断乳腺癌准确性同为100%,但对病理类型的分型略有差别。45例证实转移的患者中,Ki-67在转移淋巴结和原发灶的变异率为11.1%。当把转移灶/原发灶Ki-67比值作为研究对象时,患者乳腺癌原发分型和新辅助化疗后病理完全缓解(pCR)率之间存在统计学差异(P<0.05),年龄、乳腺癌原发灶人表皮生长因子受体2(HER-2)、分期、雌激素受体(ER)和孕激素受体(PR)比较,统计学无差异(P>0.05);行新辅助化疗后pCR单因素分析,乳腺Ki-67[95%置信区间(0.912-0.996)]及腋窝/原发灶Ki-67比值[95%置信区间(7.651-677.567)]具有相关性(P<0.05),在单因素分析中,满足P<0.1的变量被纳入多因素Logistic回归分析。结果显示,仅乳腺癌转移腋窝淋巴结/原发灶的Ki-67比值[53.698(5.425-531.538)]与患者新辅助化疗后的pCR相关(P<0.05),而乳腺原发灶的Ki-67[0.976(0.920-1.035)]与此无显著相关性(P>0.05)。结论乳腺癌转移腋窝淋巴结/原发灶分子Ki-67表达可能预测新辅助化疗后的pCR。Objective To investigate the difference and correlation between the expression of Ki-67 protein in metastatic lymph nodes and the primary breast tumor cells by immunocytochemistry reverse staining.Methods Sixty-one breast cancer patients with suspected axillary metastasis were collected from Weifang Hospital of Traditional Chinese Medicine.Ultrasound-guided fine-needle aspiration biopsy of the breast mass,coarse-needle aspiration biopsy of the primary tumor and fine needle aspiration biopsy of suspected metastatic lymph nodes of imaging assessed were performed on these patients;then to evaluate the difference during these methods.The secondary analysis was performed in 45 patients with axillary lymph node metastasis confirmed via immunocytochemistry Ki-67 reverse staining.Results In 61 patients with breast cancer,the accuracy of fine-needle aspiration biopsy and coarse-needle aspiration biopsy was both 100%,but there was a slight difference in the classification of pathological types.In 45 patients with metastasis,the variation rate of Ki-67 in metastatic lymph nodes and primary lesions was 11.1%.When armpit/primary Ki-67 ratio was performed,there were statistical differences in the primary classification and pathological complete response(PCR)after neoadjuvant chemotherapy in breast cancer(P<0.05),while there were no statistically significant differences in age,stage,estrogen receptor(ER),progestogen receptor(PR),and human epidermal growth factor receptor 2(HER-2)in primary breast cancer(P>0.05).In the single-factor analysis of PCR after neoadjuvant chemotherapy,a significant correlation was witnessed between the Ki-67 of breast cancer[0.912 and 0.996(95%confidence interval)]and the Ki-67 ratio of axillary/primary[7.651 and 677.567(95%confidence interval)](P<0.05).In univariate analysis,variables with P<0.1 were included in the multivariate logistic regression analysis.The results indicated that only the Ki-67 ratio[53.698(5.425-531.538)]of axillary lymph node/primary focus of breast cancer metastasis was relate

关 键 词：乳腺癌 转移淋巴结 细针吸取 免疫细胞化学 KI-67 

分 类 号：R737.9[医药卫生—肿瘤]