Clinic of Otorhinolaryngology, Mersin State Hospital, Mersin, Turkey.
Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.
J Int Adv Otol. 2021 Jul;17(4):306-312. doi: 10.5152/iao.2021.9453.
The aim of this study was to compare the differential Ki-67 and p27 staining properties of acquired cholesteatoma in adult patients for prognostic analysis.
Forty-two adult patients with acquired cholesteatoma were enrolled. The cholesteatoma and matched meatal skin tissues of the patients were immunostained with Ki-67 and p27 antibodies. Canal wall down mastoidectomy was performed in all patients. The differential staining properties--positive staining in the cholesteatoma and negative staining in the skin tissue (C+S-), negative staining in the cholesteatoma and positive staining in the skin tissue(C-S+)--were compared for bone erosion scores (BES), stage, and recurrence rates.
Isolated findings in the cholesteatoma tissues, without matching with the skin tissues, demonstrated that stage and recurrence rates were not related to findings in the cholesteatoma tissues (P > .05). However, C+S- for Ki-67 and C-S+ for p27 are risk factors for worse prognosis including advanced stage (P < .001 for Ki-67 and P = .008 for p27), BES values (P < .001 for Ki-67 and P = .001 for p27), and recurrence rates (P < .001 for Ki-67 and P = .037 for p27).
This is the first paper assessing the cholesteatoma prognosis according to the differential Ki-67 and p27 staining properties of cholesteatoma and healthy skin tissues. Cellular proliferation rate in the cholesteatoma is important but insufficient by itself for predicting the prognosis of cholesteatoma patients. Patients having lower basal levels of cellular proliferation rate and higher cellular activity in the cholesteatoma tissue are prone to worse prognosis with increased stage, recurrence rates, and degree of bone erosion.
本研究旨在比较成人获得性胆脂瘤的 Ki-67 和 p27 染色差异，以进行预后分析。
纳入 42 例成人获得性胆脂瘤患者。采用 Ki-67 和 p27 抗体对患者的胆脂瘤和匹配的耳道皮肤组织进行免疫染色。所有患者均行完壁式乳突切除术。比较胆脂瘤阳性染色而皮肤组织阴性染色（C+S-）、胆脂瘤阴性染色而皮肤组织阳性染色（C-S+）的染色差异，并分析其与骨侵蚀评分（BES）、分期和复发率的关系。
孤立的胆脂瘤组织发现，与皮肤组织不匹配，显示分期和复发率与胆脂瘤组织发现无关（P>.05）。然而，Ki-67 的 C+S-和 p27 的 C-S+是包括晚期（P<.001 对 Ki-67 和 P=.008 对 p27）、BES 值（P<.001 对 Ki-67 和 P=.001 对 p27）和复发率（P<.001 对 Ki-67 和 P=.037 对 p27）更差预后的危险因素。
这是第一篇根据胆脂瘤和健康皮肤组织的 Ki-67 和 p27 染色差异评估胆脂瘤预后的论文。胆脂瘤中的细胞增殖率本身虽然重要，但不足以预测胆脂瘤患者的预后。细胞增殖率较低且胆脂瘤组织中细胞活性较高的患者，其分期、复发率和骨侵蚀程度更差，预后更差。
