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目的研究 Ki-67抗原表达在良、恶性嗜铬细胞瘤鉴别诊断中的意义及其作为预测肿瘤生物学行为标志物的价值。方法采用免疫组织化学方法对57例临床确诊为良性(良性组,39例)或恶性(恶性组,18例)的嗜铬细胞瘤组织进行组织染色,检测 Ki-67抗原在嗜铬细胞瘤组织中的表达,并综合分析得出阳性指数。对两组数据进行统计学分析。结果良性及恶性组 Ki-67平均阳性指数分别为0.98%及3.78%,恶性组明显高于良性组。良性组中 Ki-67阳性指数>3%者占5.1%(2/39),恶性组中占55.6%(10/18),统计学分析两组数据差异具有统计学意义(P<0.05)。以 Ki-67阳性指数>3%为标准,对诊断恶性嗜铬细胞瘤的准确度为82.5%、灵敏度为55.6%、特异度为94.9%、阳性预测值为83.3%、阴性预测值为82.2%。随访结果显示,Ki-67高表达者术后生存率低于低表达者。结论 Ki-67抗原是检测肿瘤细胞增殖的良好标记,可用于鉴别良、恶性嗜铬细胞瘤,并对判断肿瘤的预后有着及其重要的意义。Ki-67阳性指数>3%具有区别良、恶性嗜铬细胞瘤及预测肿瘤生物学行为的意义。
Objective To investigate the significance of Ki-67 antigen expression in the differential diagnosis of benign and malignant pheochromocytoma and its value as a biomarker of predicting tumor biology. Methods Immunohistochemistry was used to stain the tissue of 57 cases of pheochromocytoma clinically diagnosed as benign (benign group, 39 cases) or malignant (malignant group, 18 cases), and to detect the expression of Ki-67 in pheochromocytoma In the expression, and a comprehensive analysis of positive index. The two groups of data for statistical analysis. Results The average positive index of Ki-67 in benign and malignant groups was 0.98% and 3.78% respectively, which was significantly higher in malignant group than in benign group. In benign group, Ki-67 positive index> 3% accounted for 5.1% (2/39), and malignant group accounted for 55.6% (10/18). There was significant difference between two groups (P <0.05). The accuracy of Ki-67 positive index> 3% was 82.5%, sensitivity was 55.6%, specificity was 94.9%, positive predictive value was 83.3%, negative predictive value was 82.2% . The follow-up results showed that Ki-67 overexpression of postoperative survival was lower than those with low expression. Conclusions Ki-67 antigen is a good marker for detecting the proliferation of tumor cells. It can be used to identify benign and malignant pheochromocytoma and has important significance in judging the prognosis of tumor. The positive index of Ki-67> 3% has the significance of distinguishing benign from malignant pheochromocytoma and predicting the biological behavior of tumor.