McKeever P E, Strawderman M S, Yamini B, Mikhail A A, Blaivas M
Department of Pathology, University of Michigan, Ann Arbor, USA.
J Neuropathol Exp Neurol. 1998 Oct;57(10):931-6. doi: 10.1097/00005072-199810000-00005.
The purpose of this study was to determine whether a relationship existed between MIB-1 labeling index (LI) percentages and survival in patients with grade II astrocytomas. From archival paraffin-embedded surgical specimens of 50 patients of the University of Michigan Medical Center with World Health Organization grade II astrocytomas, 22 patients had a Ki-67 LI of less than or equal to 2.0; and 28 patients had a MIB-1 LI of more than 2.0. Over a median follow-up interval of 10 years, ranging up to 16 years, 23% (n = 5) died of tumor in the first group while 82% (n = 23) died in the second group, a distinct difference in survival between these groups. Univariate analysis showed that a high MIB-1 predicted shorter survival (p < 0.0001), and that increased age was associated with shorter survival (p = 0.007). Gender, tumor location and radiotherapy had no significant association with survival. When adjusting for these (excluding tumor location) in the Cox proportional hazards model simultaneously, MIB-1 and age were independently prognostic. The hazard ratios were 1.301 per 1% MIB-1 LI (p = 0.0001), and 1.045 per year of age (p = 0.0028). From other studies, we know that histopathologic grade and age predict survival for glioma patients. However, even within grade II astrocytomas there is still a wide heterogeneity in how long a patient survives. We conclude that among grade II astrocytomas older patients and, independently, patients with higher MIB-1 labeling index have shorter survival.
本研究的目的是确定MIB-1标记指数（LI）百分比与II级星形细胞瘤患者生存率之间是否存在关联。从密歇根大学医学中心50例世界卫生组织II级星形细胞瘤患者的存档石蜡包埋手术标本中，22例患者的Ki-67 LI小于或等于2.0；28例患者的MIB-1 LI大于2.0。在长达16年、中位随访期为10年的时间里，第一组中有23%（n = 5）死于肿瘤，而第二组中有82%（n = 23）死亡，两组生存率存在明显差异。单因素分析显示，高MIB-1预示着生存期较短（p < 0.0001），年龄增加与生存期较短相关（p = 0.007）。性别、肿瘤位置和放疗与生存率无显著关联。在Cox比例风险模型中同时对这些因素（不包括肿瘤位置）进行校正时，MIB-1和年龄具有独立的预后价值。风险比为每1% MIB-1 LI 1.301（p = 0.0001），每年龄1.045（p = 0.0028）。从其他研究中我们知道，组织病理学分级和年龄可预测胶质瘤患者的生存期。然而，即使在II级星形细胞瘤患者中，患者的生存时间仍存在很大的异质性。我们得出结论，在II级星形细胞瘤患者中，年龄较大以及独立地，MIB-1标记指数较高的患者生存期较短。
