Sotirchos Vlasios S, Vakiani Efsevia, Sigel Carlie, Imam Rami, Kunin Henry S, Cooke Timothy M, Gönen Mithat, Solomon Stephen B, Erinjeri Joseph P, Sofocleous Constantinos T
Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, H-118, New York, NY 10065 USA.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA.
Cytotechnology. 2025 Feb;77(1):31. doi: 10.1007/s10616-024-00700-8. Epub 2024 Dec 30.
The aim of this study was to evaluate if the Ki-67 labeling index (LI) on immediate pre-ablation biopsies of colorectal liver metastases (CLM) is associated with the presence of viable tumor cells in subsequent ablation zone biopsies and/or local tumor progression-free survival (LTPFS). Biopsies of CLM were performed before and after microwave ablation (MWA), as part of a prospective clinical trial between October 2013 and May 2019. Pre-ablation biopsy slides were examined for the Ki-67 LI using light microscopy. Ablation zone biopsy specimens were evaluated for the presence of viable tumor using hematoxylin-eosin and immunohistochemistry. Differences in CLM Ki-67 LI between positive and negative for viable tumor ablation zone biopsies were assessed using the Mann-Whitney U test. Biopsy, tumor and margin data were evaluated as predictors of LTPFS using Kaplan-Meier/Cox methods. Thirty-four patients with 48 CLM underwent biopsy before and after MWA. Sufficient tissue for Ki-67 labeling was obtained in 43/48 (89.6%) CLM. Viable tumor cells were detected in 11 ablation zones (22.9%). There was no significant difference in the CLM Ki-67 LI between the positive and negative for viable tumor ablation zones (mean: 69.2% vs. 64.3% respectively, p = 0.4). Adequate ablation zone margins (> 5 mm; p = 0.029) and negative ablation zone biopsies (p = 0.009) were significant predictors of longer LTPFS. status, tumor size and Ki-67 LI were not significant predictors of LTPFS. Complete tumor ablation (with adequate margins and negative ablation zone biopsies) is the most important factor in achieving local control of CLM, even for tumors exhibiting aggressive tumor biology.
本研究的目的是评估结直肠肝转移瘤（CLM）即刻消融前活检的Ki-67标记指数（LI）是否与后续消融区活检中存活肿瘤细胞的存在和/或局部无肿瘤进展生存期（LTPFS）相关。作为2013年10月至2019年5月一项前瞻性临床试验的一部分，在微波消融（MWA）前后对CLM进行活检。使用光学显微镜检查消融前活检切片的Ki-67 LI。使用苏木精-伊红染色和免疫组织化学评估消融区活检标本中存活肿瘤的存在情况。使用Mann-Whitney U检验评估存活肿瘤消融区活检阳性和阴性之间CLM Ki-67 LI的差异。使用Kaplan-Meier/Cox方法评估活检、肿瘤和切缘数据作为LTPFS的预测指标。34例患有48个CLM的患者在MWA前后接受了活检。48个CLM中的43个（89.6%）获得了足够用于Ki-67标记的组织。在11个消融区（22.9%）检测到存活肿瘤细胞。存活肿瘤消融区阳性和阴性之间的CLM Ki-67 LI无显著差异（平均值分别为69.2%和64.3%，p = 0.4）。足够的消融区切缘（> 5 mm；p = 0.029）和消融区活检阴性（p = 0.009）是更长LTPFS的显著预测指标。肿瘤状态、肿瘤大小和Ki-67 LI不是LTPFS的显著预测指标。完全肿瘤消融（切缘足够且消融区活检阴性）是实现CLM局部控制的最重要因素，即使对于表现出侵袭性肿瘤生物学行为的肿瘤也是如此。
