Bubendorf L, Sauter G, Moch H, Schmid H P, Gasser T C, Jordan P, Mihatsch M J
Institute for Pathology, University of Basel, Switzerland.
J Pathol. 1996 Apr;178(4):437-41. doi: 10.1002/(SICI)1096-9896(199604)178:4<437::AID-PATH484>3.0.CO;2-4.
The clinical course of prostate cancer is highly variable and cannot satisfactorily be predicted by histological criteria alone. Both tumour cell proliferation and neuroendocrine differentiation have been suggested as additional prognostic parameters, neuroendocrine differentiation being considered to enhance tumour cell proliferation. This study investigated the prognostic value of tumour cell proliferation [Ki67 labelling index (LI), MIB 1] and neuroendocrine differentiation and their relationship to each other. One hundred and thirty-seven paraffin-embedded radical prostatectomy specimens were examined. Neuroendocrine differentiation was found in 58 per cent of cases, but was not associated with pTN stage, Gleason score, Ki67 LI, or tumour progression. Ki67 LI was not significantly associated with pTN stage or with Gleason score. High grade (P = 0.0005), advanced local stage (P = 0.0004), positive lymph nodes (P = 0.02), and high Ki67 LI (P = 0.0203) were predictors of tumour progression if univariate analysis was performed, but Cox stepwise regression showed that only advanced local stage (P = 0.0025) and Ki67 LI (P = 0.0105) were independent predictors of tumour progression, the relative risk being 3.6 and 2.5, respectively. It is concluded that Ki67 is an important prognostic marker in prostate cancer with a potential for routine application.
前列腺癌的临床病程高度多变，仅靠组织学标准无法令人满意地进行预测。肿瘤细胞增殖和神经内分泌分化均被认为是额外的预后参数，神经内分泌分化被认为可增强肿瘤细胞增殖。本研究调查了肿瘤细胞增殖[Ki67标记指数（LI）、MIB 1]和神经内分泌分化的预后价值及其相互关系。对137例石蜡包埋的前列腺癌根治术标本进行了检查。58%的病例中发现有神经内分泌分化，但与pTN分期、Gleason评分、Ki67 LI或肿瘤进展无关。Ki67 LI与pTN分期或Gleason评分无显著相关性。单因素分析时，高分级（P = 0.0005）、局部晚期（P = 0.0004）、淋巴结阳性（P = 0.02）和高Ki67 LI（P = 0.0203）是肿瘤进展的预测因素，但Cox逐步回归显示只有局部晚期（P = 0.0025）和Ki67 LI（P = 0.0105）是肿瘤进展的独立预测因素，相对风险分别为3.6和2.5。结论是，Ki67是前列腺癌中一个重要的预后标志物，具有常规应用的潜力。
