Department of Abdominal and General Surgery, University Medical Centre Maribor, Maribor, Slovenia.
HPB (Oxford). 2014 Mar;16(3):235-42. doi: 10.1111/hpb.12089. Epub 2013 Mar 19.
The aim of this study was to assess whether biological markers can provide prognostic information additional to that supplied by the clinical risk score (CRS) in patients with colorectal liver metastases.
A retrospective review of a prospectively maintained database was conducted. Patients selected for this study were treated between 1996 and 2011 with potentially curative liver surgery. Expressions of p53, Ki-67 and thymidylate synthase were assayed using immunohistochemical techniques on tissue microarrays.
A total of 98 (24%) of 406 patients met the inclusion criteria. The median follow-up was 103 months. Analysis revealed a correlation between p53 protein overexpression and high CRS (P = 0.058). Following multivariate analysis, only high CRS remained as an independent negative prognostic predictor of survival (P = 0.018), as well as an indicator of early recurrence of disease (P = 0.010). Of the biological markers investigated, only Ki-67 overexpression was identified as a positive predictor of survival on multivariate analysis (P = 0.038).
Ki-67 overexpression was a positive predictor of survival. Only high CRS remained an independent negative prognostic predictor.
本研究旨在评估生物标志物是否可以提供除临床风险评分（CRS）以外的预后信息，这些信息适用于结直肠癌肝转移患者。
对前瞻性维护的数据库进行了回顾性分析。本研究选择的患者于 1996 年至 2011 年间接受了潜在可治愈的肝切除术治疗。使用组织微阵列上的免疫组织化学技术检测 p53、Ki-67 和胸苷酸合成酶的表达。
在 406 名患者中，共有 98 名（24%）符合纳入标准。中位随访时间为 103 个月。分析显示，p53 蛋白过表达与高 CRS 之间存在相关性（P = 0.058）。多变量分析后，仅高 CRS 仍然是生存的独立负预后预测因子（P = 0.018），也是疾病早期复发的指标（P = 0.010）。在所研究的生物标志物中，只有 Ki-67 过表达在多变量分析中被确定为生存的阳性预测因子（P = 0.038）。
Ki-67 过表达是生存的阳性预测因子。只有高 CRS 仍然是独立的负预后预测因子。
