Henrique R, Azevedo R, Bento M J, Domingues J C, Silva C, Jerónimo C
Department of Pathology, The Portuguese Cancer Institute-Porto Regional Centre, Portugal.
J Am Acad Dermatol. 2000 Dec;43(6):991-1000. doi: 10.1067/mjd.2000.109282.
The proliferative activity of some tumors is related to the development of metastatic disease and survival. Thus it could be used as a potential prognostic variable.
The purpose of this study was to determine the prognostic value of the Ki-67 index and of a "proliferation-based prognostic index" (PBPI, derived as tumor thickness x Ki-67 index/100) in localized cutaneous malignant melanoma (CMM).
The Ki-67 index (percent of total tumor nuclei) was determined in a series of 84 localized CMMs, with the use of the alkaline phosphatase-antialkaline phosphatase labeling method in formalin-fixed, paraffin-embedded material, and was correlated with other prognostic variables. Survival analysis was performed to determine whether the Ki-67 index and the PBPI could be predictive of metastatic spread or recurrent disease. A stratified analysis of these two parameters according to the tumor thickness was done.
An association among the Ki-67 index and location, Clark level, tumor thickness and stage, and prognostic index was detected. Increased Ki-67 index and PBPI were associated with poorer overall survival (P =.03 and P <.0001, respectively) and disease-free survival (P =.01 and P <.0001, respectively). However, after stratification for thickness, only the PBPI showed independent prognostic significance, restricted to tumors thicker than 4 mm (P =. 03).
The determination of the PBPI in CMM conveys prognostic information for localized thick (>4 mm) CMM, identifying two groups of patients with distinct outcome.
某些肿瘤的增殖活性与转移性疾病的发展及生存率相关。因此，它可作为一个潜在的预后变量。
本研究旨在确定Ki-67指数和“基于增殖的预后指数”（PBPI，计算方法为肿瘤厚度×Ki-67指数/100）在局限性皮肤恶性黑色素瘤（CMM）中的预后价值。
采用碱性磷酸酶-抗碱性磷酸酶标记法，在84例局限性CMM的福尔马林固定、石蜡包埋材料中测定Ki-67指数（肿瘤细胞核总数的百分比），并将其与其他预后变量进行关联分析。进行生存分析以确定Ki-67指数和PBPI是否可预测转移扩散或复发性疾病。根据肿瘤厚度对这两个参数进行分层分析。
检测到Ki-67指数与肿瘤位置、Clark分级、肿瘤厚度和分期以及预后指数之间存在关联。Ki-67指数和PBPI升高分别与较差的总生存率（P = 0.03和P < 0.0001）和无病生存率（P = 0.01和P < 0.0001）相关。然而，在按厚度分层后，只有PBPI显示出独立的预后意义，仅限于厚度大于4 mm的肿瘤（P = 0.03）。
在CMM中测定PBPI可为局限性厚（>4 mm）CMM提供预后信息，识别出两组预后不同的患者。
