Gasinska A, Urbanski K, Gruchala A, Biesaga B, Kojs Z
Laboratory of Radiation Biology, Centre of Oncology, Krakow, Poland.
Neoplasma. 2002;49(6):379-86.
The prognostic significance of apoptotic (AI) and mitotic (MI) indices, and the ratio of these parameters (AI/MI), MIB-1 labeling index (MIB-1LI) and proliferation pattern was studied in 130 (FIGO stage IB-IIIB) squamous cervical cancer patients before radiotherapy. Also the influence of the patients age and tumors pathological features (stage, grade, degree of keratinization) and DNA ploidy on the biological parameters were analysed. AI and MI were assessed on histological sections stained with hematoxylin and eosin, and the MIB-1LI on specimens stained with rabbit anti-human Ki-67 antibody (DAKO Ltd). Sections stained with MIB-1 antibody were used for assessment of the tumor proliferation pattern. The median age of the patients was 55 years (29-80). The median values for MIB-1LI, AI, MI, AI/MI, were: 52.3%, 1.1%, 1.5, and 0.9, respectively. In the univariate analysis median values for cut-off points were used for MIB-1LI, and AI, however, for other parameters significant cut-off points have been chosen. For MI it was 2.6 and for the AI/MI ratio 0.7. The median time of follow-up was 29 months, with a range of 2-145 months. The univariate analysis showed that tumor stage (p=0.7009), grade (p=0.6660) and AI (p=0.9378) had negligible influence on patients survival. However, MI >2.6 (p=0.0442), AI/MI <or=0.7 (p=0.0190), and random or mixed type of proliferation (p=0.0163) were significant prognostic factors. Cox multivariate analysis showed that MI, AI/MI, degree of keratinization and type of proliferation were significant prognostic factors for cervical cancer patients treated with radiotherapy.
对130例（国际妇产科联盟分期为IB-IIIB期）宫颈癌鳞状细胞癌患者放疗前的凋亡指数（AI）、有丝分裂指数（MI）、这些参数的比值（AI/MI）、MIB-1标记指数（MIB-1LI）及增殖模式的预后意义进行了研究。同时分析了患者年龄、肿瘤病理特征（分期、分级、角化程度）及DNA倍性对生物学参数的影响。AI和MI在苏木精和伊红染色的组织切片上进行评估，MIB-1LI在兔抗人Ki-67抗体（DAKO有限公司）染色的标本上进行评估。用MIB-1抗体染色的切片用于评估肿瘤增殖模式。患者的中位年龄为55岁（29 - 80岁）。MIB-1LI、AI、MI、AI/MI的中位值分别为：52.3%、1.1%、1.5和0.9。在单因素分析中，MIB-1LI和AI使用中位值作为截断点，然而，对于其他参数则选择了显著的截断点。MI的截断点为2.6，AI/MI比值的截断点为0.7。中位随访时间为29个月，范围为2 - 145个月。单因素分析显示，肿瘤分期（p = 0.7009）、分级（p = 0.6660）和AI（p = 0.9378）对患者生存的影响可忽略不计。然而，MI > 2.6（p = 0.0442）、AI/MI≤0.7（p = 0.0190）以及随机或混合类型的增殖（p = 0.0163）是显著的预后因素。Cox多因素分析显示，MI、AI/MI、角化程度和增殖类型是接受放疗的宫颈癌患者的显著预后因素。
