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目的:为探究不同病理类型的肺磨玻璃结节(ground-glass opacity,GGO)中ki-67的表达情况及其与肺癌相关标志物p53、p63、EGFR等表达的相关性。方法:收集从2012年10月至2014年10月我院胸外科收治的254例GGO病人的临床病史、影像、病理及血常规等资料予以回顾性分析。结果:Ki-67表达量从良性组(n=66),不典型腺瘤样增生(atypical adenomatous hyperplasia,AAH,n=27),到原位癌(adenocarcinoma in situ,AIS,n=11),微浸润腺癌(minimally invasive adenocarcinoma,MIA,n=108),最后到浸润性腺癌(invasive adenocarcinoma,IAC,n=42)即随着早期肺癌的演进过程不断增高。Ki-67与各标志物的相关系数为0.386(p53,P<0.001)、0.227(EGFR,P=0.024)、0.441(CEA,P<0.001)。通过ROC曲线分析得到ki-67来判别良恶性GGO的曲线下面积和最佳阈值,也得到了早期肺癌演进过程中ki-67阈值变化。恶性GGO组全血细胞中平均单核细胞含量低于良性组GGO,且差异有统计学意义。结论:ki-67表达量在不同病理类别的GGO中有显著性差异,且在肺癌演进过程中依次增高,可作为鉴别早期肺癌不同病理类型的参考依据和预后因子;ki-67与P53、EGFR及CEA的表达具有一定的相关性。
Objective: To investigate the expression of ki-67 in ground-glass opacity (GGO) of different pathological types and its correlation with the expressions of p53, p63 and EGFR in lung cancer. Methods: The clinical data of 254 GGO patients admitted to our hospital from October 2012 to October 2014 were retrospectively analyzed. Results: The expression of Ki-67 was significantly higher than that in benign group (n = 66), atypical adenomatous hyperplasia (AAH, n = 27), and adenocarcinoma in situ Minimally invasive adenocarcinoma (MIA, n = 108) and finally to invasive adenocarcinoma (IAC, n = 42) are increasing with the progression of early lung cancer. The correlation coefficient of Ki-67 with each marker was 0.386 (P <0.001), 0.227 (EGFR, P = 0.024), 0.441 (CEA, P <0.001). Ki-67 was obtained by ROC curve analysis to determine the area under the curve and the optimal threshold of benign and malignant GGO. The ki-67 threshold was also obtained during the evolution of early lung cancer. The average mononuclear cell content of malignant GGO group was lower than that of benign group, and the difference was statistically significant. Conclusion: The expression of ki-67 in different pathological categories of GGO were significantly different, and increased in turn during lung cancer progression, which can be used as a reference to identify different pathological types of early lung cancer and prognostic factors; ki-67 and P53, EGFR And CEA expression has some relevance.