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目的探讨非浸润性膀胱尿路上皮肿瘤的组织学形态及Ki-67、c-erbB-2表达的意义。方法依据WHO(2004)泌尿系统肿瘤中ISUP分类标准进行组织学观察及分类。应用免疫组化方法检测70例膀胱尿路上皮肿瘤标本中Ki-67、c-erbB-2的表达水平,并对其进行3～60个月随访。结果在尿路上皮乳头状瘤(UP)、乳头状肿瘤低恶性潜能(PUNLMP)、低级别乳头状尿路细胞癌(LGPUC)和高级别乳头状尿路细胞癌(HGPUC)中,Ki-67(L)分别为4.05±2.3、13.8±6.9、30.1±4.4和59.5±6.8;c-erbB-2与组织学分级有关(P<0.01)。UP患者随访无复发;PUNLMP复发率为15%(3/20),LGPUC复发率为65%(13/20),HGPUC复发率为70%(7/10)。结论Ki-67和c-erbB-2可作为膀胱尿路上皮肿瘤细胞增殖程度及组织学诊断的参考指标。
Objective To investigate the histological morphology and the expression of Ki-67 and c-erbB-2 in non-invasive bladder urothelial carcinoma. Methods According to WHO (2004) urinary system tumors ISUP classification criteria for histological observation and classification. The expression of Ki-67 and c-erbB-2 in 70 specimens of bladder urothelial carcinoma was detected by immunohistochemistry and followed up for 3-60 months. Results Ki-67 was significantly higher in patients with UP, PUNLMP, LGPUC and HGPUC, (L) were 4.05 ± 2.3, 13.8 ± 6.9, 30.1 ± 4.4 and 59.5 ± 6.8 respectively; c-erbB-2 was associated with histological grade (P <0.01). UP patients were followed up without recurrence; PUNLMP recurrence rate was 15% (3/20), LGPUC recurrence rate was 65% (13/20), HGPUC recurrence rate was 70% (7/10). Conclusions Ki-67 and c-erbB-2 can be used as reference markers for the proliferation of bladder urothelial cells and histological diagnosis.