Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany.
Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany.
World Neurosurg. 2019 May;125:e1093-e1103. doi: 10.1016/j.wneu.2019.02.006. Epub 2019 Feb 18.
Previous research has shown a strong correlation between the Ki-67 proliferation index and grade of malignancy in astrocytoma. Ki-67 has also shown encouraging results as a prognostic marker for patients' overall survival (OS). We focus on whether the index is linked to the appearance of glioblastoma on pretreatment magnetic resonance imaging (MRI) or to OS.
In our retrospective study, only isocitrate dehydrogenase IDH wild-type glioblastoma was included (n = 152). Ki-67 index was quantified via immunohistochemistry. On all pretreatment MRI, tumor compartments (tumor, necrosis, and edema) were volumetrically assessed. An OS subpopulation was filtered from the total cohort (residual tumor volume ≤2 cm). In addition, a propensity score matching was executed.
All volumetric assessed tumor volumes correlated with each other (P ≤ 0.011), although the Ki-67 index showed no correlation with any of the measured volumes. Concerning the OS, a cutoff value of 20% for the Ki-67 index showed a significant influence on patients' OS in multivariate analysis (P = 0.043).
The unique appearance of every glioblastoma on MRI seems to be independent of the Ki-67 index. Furthermore, the Ki-67 index did show a distinct prognostic value for OS within our cohort at a cutoff value of 20% for Ki-67.
先前的研究表明，星形细胞瘤的 Ki-67 增殖指数与恶性程度之间存在很强的相关性。Ki-67 作为患者总生存期（OS）的预后标志物也取得了令人鼓舞的结果。我们专注于该指数是否与胶质母细胞瘤在预处理磁共振成像（MRI）上的表现有关，或者与 OS 有关。
在我们的回顾性研究中，仅纳入异柠檬酸脱氢酶 IDH 野生型胶质母细胞瘤（n=152）。通过免疫组织化学对 Ki-67 指数进行量化。在所有预处理 MRI 上，对肿瘤区室（肿瘤、坏死和水肿）进行容积评估。从总队列中筛选出 OS 亚组（残留肿瘤体积≤2cm）。此外，还执行了倾向评分匹配。
所有容积评估的肿瘤体积彼此相关（P≤0.011），尽管 Ki-67 指数与任何测量体积均无相关性。关于 OS，Ki-67 指数的 20%截断值在多变量分析中对患者的 OS 有显著影响（P=0.043）。
MRI 上每个胶质母细胞瘤的独特表现似乎与 Ki-67 指数无关。此外，在我们的队列中，Ki-67 指数的 20%截断值显示出明显的预后价值，与 OS 相关。
