Quintero A, Alvarez-Kindelan J, Luque R J, Gonzalez-Campora R, Requena M J, Montironi R, Lopez-Beltran A
Biomedical Research Unit, Reina Sofia University Hospital and Cordoba University Medical School, 14004 Cordoba, Spain.
J Clin Pathol. 2006 Jan;59(1):83-8. doi: 10.1136/jcp.2004.022939.
To evaluate whether ki-67 labelling index (LI) has independent prognostic value for survival of patients with bladder urothelial tumours graded according to the 2004 World Health Organisation classification.
Ki-67 LI was evaluated in 164 cases using the grid counting method. Non-invasive (stage Ta) tumours were: papilloma (n = 5), papillary urothelial neoplasia of low malignant potential (PUNLMP; n = 26), and low (LG; n = 34) or high grade (HG; n = 15) papillary urothelial carcinoma. Early invasive (stage T1) tumours were: LG (n = 58) and HG (n = 26) carcinoma. Statistical analysis included Fisher and chi2 tests, and mean comparisons by ANOVA and t test. Univariate and multivariate survival analyses were performed according to the Kaplan-Meier method with log rank test and Cox's proportional hazard method.
Mean ki-67 LI increased from papilloma to PUNLMP, LG, and HG in stage Ta (p<0.0001) and from LG to HG in stage T1 (p = 0.013) tumours. High tumour proliferation (>13%) was related to greater tumour size (p = 0.036), recurrence (p = 0.036), progression (p = 0.035), survival (p = 0.054), and high p53 accumulation (p = 0.015). Ki-67 LI and tumour size were independent predictors of disease free survival (DFS), but only ki-67 LI was related to progression free survival (PFS). Cancer specific overall survival (OS) was related to ki-67 LI, tumour size, and p27kip1 downregulation. Ki-67 LI was the main independent predictor of DFS (p = 0.0005), PFS (p = 0.0162), and cancer specific OS (p = 00195).
Tumour proliferation measured by Ki-67 LI is related to tumour recurrence, stage progression, and is an independent predictor of DFS, PFS, and cancer specific OS in TaT1 bladder urothelial cell carcinoma.
评估根据2004年世界卫生组织分类分级的膀胱尿路上皮肿瘤患者中，Ki-67标记指数（LI）对生存是否具有独立的预后价值。
采用网格计数法对164例病例进行Ki-67 LI评估。非侵袭性（Ta期）肿瘤包括：乳头状瘤（n = 5）、低恶性潜能乳头状尿路上皮肿瘤（PUNLMP；n = 26）以及低级别（LG；n = 34）或高级别（HG；n = 15）乳头状尿路上皮癌。早期侵袭性（T1期）肿瘤包括：LG（n = 58）和HG（n = 26）癌。统计分析包括Fisher检验和卡方检验，以及通过方差分析和t检验进行均值比较。根据Kaplan-Meier法进行单因素和多因素生存分析，并采用对数秩检验和Cox比例风险法。
在Ta期肿瘤中，从乳头状瘤到PUNLMP、LG和HG，Ki-67 LI均值逐渐升高（p<0.0001）；在T1期肿瘤中，从LG到HG，Ki-67 LI均值也升高（p = 0.013）。高肿瘤增殖（>13%）与更大的肿瘤大小（p = 0.036）、复发（p = 0.036）、进展（p = 0.035）、生存（p = 0.054）以及高p53积聚（p = 0.015）相关。Ki-67 LI和肿瘤大小是无病生存（DFS）的独立预测因素，但只有Ki-67 LI与无进展生存（PFS）相关。癌症特异性总生存（OS）与Ki-67 LI、肿瘤大小和p27kip1下调相关。Ki-67 LI是DFS（p = 0.0005）、PFS（p = 0.0162）和癌症特异性OS（p = 0.0195）的主要独立预测因素。
通过Ki-67 LI测量的肿瘤增殖与肿瘤复发、分期进展相关，并且是TaT1期膀胱尿路上皮细胞癌DFS、PFS和癌症特异性OS的独立预测因素。
