Müller W, Schneiders A, Meier S, Hommel G, Gabbert H E
Institute of Pathology, Heinrich-Heine-University, University of Mainz, Germany.
Br J Cancer. 1996 Sep;74(5):759-65. doi: 10.1038/bjc.1996.433.
The prognostic significance of tumour cell proliferation was investigated in a series of 418 gastric carcinomas using the monoclonal antibody MIB-1. Owing to strong intratumoural heterogeneity of MIB-1 expression three different proliferation indices (PIs) were determined in all carcinomas: (1) PImax in areas of maximal tumour cell proliferation, (2) PIrand in areas randomly distributed over the whole tumour. (3) PIfront in areas exclusively located at the tumour invasion front. There was a strong intertumoral heterogeneity with PImax ranging from 4.9% to 92.2%, PIrand ranging from 3.4% to 81.4% and PIfront ranging from 4.2% to 87.1%. The mean values were 51.3% +/- 19.7 for PImax, 34.2% +/- 18.3 for PIrand and 37.2% +/- 19.5 for PIfront. Whereas no statistically significant correlation could be found between proliferative activity and the clinicopathological parameters depth of invasion, lymph node involvement or grade of tumour differentiation, there was a positive correlation between a high proliferation index at the tumour invasion front (PIfront) and the presence of blood or lymphatic vessel invasion. No significant correlation could be demonstrated between the different proliferation indices and survival, even when different subgroups of patients were analysed separately. The present results suggest that the immunohistochemical evaluation of the proliferation activity has no predictive value for the prognosis of gastric cancer patients or the identification of subgroups of patients who may be at higher risk.
利用单克隆抗体MIB - 1对418例胃癌患者进行研究，以探讨肿瘤细胞增殖的预后意义。由于MIB - 1表达在肿瘤内具有很强的异质性，因此在所有癌症中确定了三种不同的增殖指数（PI）：（1）肿瘤细胞增殖最活跃区域的PI最大值（PImax）；（2）整个肿瘤随机分布区域的PI随机值（PIrand）；（3）仅位于肿瘤浸润前沿区域的PI前沿值（PIfront）。肿瘤间存在很强的异质性，PImax范围为4.9%至92.2%，PIrand范围为3.4%至81.4%，PIfront范围为4.2%至87.1%。PImax的平均值为51.3%±19.7，PIrand为34.2%±18.3，PIfront为37.2%±19.5。虽然在增殖活性与临床病理参数（浸润深度、淋巴结受累情况或肿瘤分化程度）之间未发现统计学上的显著相关性，但肿瘤浸润前沿的高增殖指数（PIfront）与血管或淋巴管侵犯的存在呈正相关。即使对不同亚组患者分别进行分析，不同增殖指数与生存率之间也未显示出显著相关性。目前的结果表明，增殖活性的免疫组化评估对胃癌患者的预后或识别可能处于较高风险的患者亚组没有预测价值。
