Cordone I, Matutes E, Catovsky D
Academic Department of Hematology and Cytogenetics, Royal Marsden Hospital, London, UK.
Leukemia. 1992 Sep;6(9):902-6.
Ki-67 is a monoclonal antibody that recognises a nuclear antigen expressed during most phases of the cell cycle. We have analysed, by immunocytochemistry, the frequency, morphology, and clinical significance of Ki-67+ cells in 108 patients with B-cell chronic lymphocytic leukemia (CLL). Because in normal peripheral blood Ki-67+ cells are mainly T lymphocytes, we have also investigated, by double immunoenzymatic staining, the proportion of Ki-67+ T cells (Ki-67/CD3+) in CLL. Four groups of patients were identified: (i) 47 with stage A, (ii) 32 with stages B + C, (iii) 24 with greater than 10% of circulating prolymphocytes (CLL/PL) and (iv) five with Richter's syndrome. Within stage A CLL, two groups were considered: A' (Hb greater than or equal to 12 g/dl and lymphocytes less than 30 + 10(9)/l) and A" (Hb less than 12 g/dl or lymphocytes greater than or equal to 30 x 10(9)/l). The percentage and absolute number of Ki-67+ leukemic cells was found to increase with the stage of the disease and correlate with the proportion of prolymphocytes. On the other hand, the proportion of Ki-67+ T cells (CD3+) was significantly higher in patients with CLL stage A' (29.3 +/- 4.5), which includes patients with long-standing, stable disease, than in CLL stage A" (9.5 +/- 3.3), B + C (7.1 +/- 4.6), and CLL/PL (6.4 +/- 2.8). Ki-67 seems to identify patients with more aggressive forms of CLL, such as CLL/mu 2PL with more than 10% Ki-67+ cells (25% of the cases) and Richter's syndrome, in which all the large lymphoma cells are Ki-67+. Long-term follow-up will establish whether Ki-67 is a good prognostic marker and can predict disease outcome.
Ki-67是一种单克隆抗体，可识别在细胞周期的大多数阶段表达的一种核抗原。我们通过免疫细胞化学分析了108例B细胞慢性淋巴细胞白血病（CLL）患者中Ki-67+细胞的频率、形态及临床意义。由于在正常外周血中Ki-67+细胞主要是T淋巴细胞，我们还通过双重免疫酶染色研究了CLL中Ki-67+ T细胞（Ki-67/CD3+）的比例。确定了四组患者：（i）47例处于A期，（ii）32例处于B + C期，（iii）24例循环前淋巴细胞（CLL/PL）大于10%，（iv）5例患有Richter综合征。在A期CLL内，又分为两组：A'（血红蛋白大于或等于12 g/dl且淋巴细胞小于30 + 10⁹/l）和A"（血红蛋白小于12 g/dl或淋巴细胞大于或等于30×10⁹/l）。发现Ki-67+白血病细胞的百分比和绝对数量随疾病分期增加，并与前淋巴细胞的比例相关。另一方面，处于A'期CLL（包括病情长期稳定的患者）的患者中Ki-67+ T细胞（CD3+）的比例（29.3±4.5）显著高于A"期CLL（9.5±3.3）、B + C期（7.1±4.6）和CLL/PL期（6.4±2.8）。Ki-67似乎可识别具有更侵袭性CLL形式的患者，如Ki-67+细胞超过10%的CLL/μ2PL（25%的病例）和Richter综合征，其中所有大淋巴瘤细胞均为Ki-67+。长期随访将确定Ki-67是否是一个良好的预后标志物以及能否预测疾病转归。
