[前列腺癌的预后因素：Ki-67表达在术前活检中的应用价值]

[Prognostic factors of prostate cancer: usefulness of Ki-67 expression in preoperative biopsies].

作者信息

Ojea Calvo Antonio, Mosteiro Cerviño Martín José, Domínguez Freire Fernando, Alonso Rodrigo Arturo, Rodríguez Iglesias Benito, Benavente Delgado Juan, Barros Rodríguez José Manuel, González Piñeiro Ana

机构信息

Servicio de Urología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.

出版信息

Arch Esp Urol. 2004 Oct;57(8):805-16.

PMID:15560269

Abstract

OBJECTIVES

To evaluate the usefulness of Ki-67 expression in preoperative diagnostic biopsies to predict prostate cancer biochemical relapse after radical prostatectomy.

METHODS

We analyze the expression of Ki-67 in ultrasound guided biopsies of 103 patients who underwent radical prostatectomy. Mean follow-up was 3.4 years (1.3-8.8 yr.). We correlated biochemical progression with traditional prognostic factors such as PSA (> 10/< or = 10), Gleason (> or = 7/< 7), pT classification (pT3/pT 0-2), and the immunohistochemical prognostic factor Ki-67 (> 3%/< or = 3%).

RESULTS

71/103 (69%) patients did not have progression and 32 (31%) had biochemical progression. Mean preoperative PSA was 10.7 ng/ml in patients without progression and 20.90 ng/ml in patients with biochemical progression (p = 0.0001). Mean Gleason score was 6.03 in patients without progression and 6.75 in patients with biochemical progression (p = 0.0001). Ki-67 expression was 3.95% in patients without progression in comparison to 5.05% of patients with biochemical progression. 12/67 (17.9%) of pT 0-2 tumors and 20/36 (55.6%) pT3 tumors progressed (p = 0.0001). Multivariate analysis indicates that there is not relationship between Ki-67 (> 3% < or = 3%) in preoperative biopsy specimens and prostate cancer biochemical progression after radical prostatectomy (p = 0.204).

CONCLUSIONS

The immunohistochemical prognostic factor Ki-67 (> 3%/< or = 3%) in preoperative biopsies is less effective than classic factors, PSA (> 10/< or = 10), Gleason score (> or = 7/< 7) and pT classification (pT3/pT 0-2), to predict prostate cancer biochemical progression after radical prostatectomy.

摘要

目的

评估术前诊断性活检中Ki-67表达对预测前列腺癌根治术后生化复发的有用性。

方法

我们分析了103例行前列腺癌根治术患者超声引导下活检标本中Ki-67的表达情况。平均随访时间为3.4年（1.3 - 8.8年）。我们将生化进展与传统预后因素进行关联分析，这些因素包括前列腺特异性抗原（PSA）（>10/<或 = 10）、Gleason评分（>或 = 7/< 7）、pT分期（pT3/pT 0 - 2）以及免疫组化预后因素Ki-67（>3%/<或 = 3%）。

结果

103例患者中，71例（69%）未出现进展，32例（31%）出现生化进展。未进展患者术前平均PSA为10.7 ng/ml，生化进展患者为20.90 ng/ml（p = 0.0001）。未进展患者平均Gleason评分为6.03，生化进展患者为6.75（p = 0.0001）。未进展患者的Ki-67表达为3.95%，生化进展患者为5.05%。pT 0 - 2期肿瘤中有12/67例（17.9%）进展，pT3期肿瘤中有20/36例（55.6%）进展（p = 0.0001）。多因素分析表明，术前活检标本中Ki-67（>3%/<或 = 3%）与前列腺癌根治术后生化进展之间无相关性（p = 0.204）。