de Manzoni G, Verlato G, Tomezzoli A, Guglielmi A, Pelosi G, Ricci F, Di Leo A, Cordiano C
First Department of General Surgery, University of Verona, Italy.
Jpn J Clin Oncol. 1998 Sep;28(9):534-7. doi: 10.1093/jjco/28.9.534.
Cell proliferation characteristics may reflect the aggressiveness of gastric tumors and their eventual prognosis. The aim of this study was to evaluate whether the proliferative activities determined by the antibody Ki-67 could be used as a prognostic predictor in patients affected by advanced gastric cancer.
The prognostic significance of proliferative activity was investigated in 56 patients who underwent curative gastrectomy (R0) for advanced gastric cancer using the monoclonal antibody Ki-67. The patients were divided into three groups according to the Ki-67 labeling index of the tumors: < 10% (18 cases), 10-40% (21 cases) and > 40% (17 cases). The Cox regression model was used to evaluate the prognostic significance of the Ki-67 index controlling for age, gender, histology, depth of tumor invasion and node metastasis.
There was no significant relationship between the Ki-67 index and wall invasion (P = 0.80) or nodal status (P = 0.73). The cumulative 3-year survival rates (95% Cl) were 61.0% (35.3-79.2%) in patients with Ki-67 index < 10%, 52.4% (29.7-70.9%) with Ki-67 index 10-40% and 52.9% (27.6-73.0%) with Ki-67 index > 40% and the differences were not statistically significant (P = 0.93). Also in multivariate analysis the proliferative activity did not independently affect survival (P = 0.98). An interaction between Ki-67 index and age was found and Ki-67 index > 40% was significantly associated with a poor prognosis in patients over 68 years old (P = 0.004).
Our study indicated that the proliferative activity in gastric cancer, determined with the monoclonal antibody Ki-67, does not influence the survival except in elderly patients (> or = 68 years old).
细胞增殖特性可能反映胃肿瘤的侵袭性及其最终预后。本研究的目的是评估由抗体Ki-67测定的增殖活性是否可用作晚期胃癌患者的预后预测指标。
使用单克隆抗体Ki-67对56例行根治性胃切除术（R0）的晚期胃癌患者的增殖活性的预后意义进行了研究。根据肿瘤的Ki-67标记指数将患者分为三组：<10%（18例）、10 - 40%（21例）和>40%（17例）。采用Cox回归模型评估在控制年龄、性别、组织学、肿瘤浸润深度和淋巴结转移的情况下Ki-67指数的预后意义。
Ki-67指数与壁层浸润（P = 0.80）或淋巴结状态（P = 0.73）之间无显著关系。Ki-67指数<10%的患者3年累积生存率（95%CI）为61.0%（35.3 - 79.2%），Ki-67指数为10 - 40%的患者为52.4%（29.7 - 70.9%），Ki-67指数>40%的患者为52.9%（27.6 - 73.0%），差异无统计学意义（P = 0.93）。在多变量分析中，增殖活性也未独立影响生存率（P = 0.98）。发现Ki-67指数与年龄之间存在交互作用，Ki-67指数>40%与68岁以上患者的预后不良显著相关（P = 0.004）。
我们的研究表明，用单克隆抗体Ki-67测定的胃癌增殖活性除了在老年患者（≥68岁）中外，不影响生存率。
