晚期肺癌ki-67表达水平与生存期的相关性研究
摘要
目的:回顾性分析晚期肺癌患者ki-67表达水平与生存期及治疗的相关性以期为晚期肺癌的临床决策提供参考。方法:选取2013年1月～2018年5月经病理确诊为肺癌患者94例为研究对象,根据肺癌患者的ki-67表达水平分为高水平组(≥30%)68例,低水平组(<30%)26例。在两组中根据是否接受化疗、放疗、靶向治疗及呼吸内镜下介入治疗再分为治疗组与非治疗组(放弃治疗)。统计分析不同ki-67水平的肺癌患者治疗与非治疗组间生存期差异。将接受治疗患者按病理类型分出亚组(鳞癌与腺癌),再比较各亚组中接受化疗和靶向治疗患者的生存期,分析不同治疗方案肺癌患者生存期差异。结果:ki-67高表达组68例,中位生存期4个月,ki-67低表达组26例,中位生存期7个月,两组比较,差异有统计学意义(P<0.05)。Ki-67低表达组中治疗组16例,中位生存期9个月,非治疗组10例,中位生存期4.5个月,两组比较,差异有统计学意义(P<0.01)。Ki-67高表达组中治疗组54例,中位生存期5个月,非治疗组14例,中位生存期4个月,两组比较,差异无统计学意义(P>0.05)。Ki-67高表达肺癌患者,鳞癌接受化疗12例,中位生存期7个月,接受靶向治疗6例,中位生存期10个月,两种治疗方法比较,差异无统计学意义(P>0.05)。腺癌接受化疗20例,中位生存期5个月,接受靶向治疗10例,中位生存期7个月,两种治疗方法比较,差异无统计学意义(P>0.05)。结论:Ki-67可作为晚期肺癌生存期预测指标,可对晚期肺癌患者临床治疗决策提供一定的参考与帮助:肺癌晚期ki-67低表达患者,预计生存期长,接受治疗患者较未治疗患者生存期延长约6个月;ki-67高表达患者,预计生存期短,接受治疗患者与未接受治疗患者生存期未见明显延长;Ki-67高表达腺癌与鳞癌患者,靶向治疗似乎较化疗生存期有延长,但差异无统计学意义(P>0.05)。
引文
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[9] 张连美,仲纪祥,孙苏安.EGFR,ALK和Ki-67在非小细胞肺癌中的表达及相关分析[J].临床肺科杂志,2017,22(1):4.
[10] 张煜坤,戈伟.Ki-67与非小细胞肺癌患者EGFR突变的关系及其对预后的影响[J].中国医药导报,2017,14(32):79.
[11] 姚林军,杜彦丹,李英智,等.肿瘤标志物在肺癌检验中的临床应用分析[J].吉林医学,2014,35(5):997.
[2] Che WJ,He DS,Tang RX,et al. Ki-67 is a baluable prognostic factor in gliomas:Evidence from a systemmatic review and metaanalysis[J].Asian Pac J Cancer Prev,2015,16(2):411.
[3] Adem Karaman,Irmak.Durur-Subasi,Fatih Alper,et al. Correlation of diffusion MRI with the ki-67 index in non-small cell lung cancer[J].Radiol Oncol,2015,49(3):250.
[4] Viber L,Papotti M,Abbona CC,et al.Valuce of ki-67 immunostaining in preoperative biopsies of carcinomas of the lung [J].Hum Pathol,1997,28(2):189.
[5] Sikora J,Dworacki G,Trybus M,et al.Correlation between DNA cootent expression of ki-67 antigon of tumor cells an immunophenotype of lymphocytes from inalignant pleural effusions[J]. Tumor biol,1998,19(3):196.
[6] Hommura F,Dosaka-Akta H,Mishina T,et al.Prognostic signifcance of p27kipi protein an ki-67 groeth fraction in non-small cell lung cancers[J].Clin Cancer Res,2000,6(10):4073.
[7] Shiba M,Kakizawak,Kohno H,et al.Prognostic implication of ki-67 immunostaining in treating subclinical pleural cancer found at thoracotomy in lung cancer patients[J].Ann Thorac Surg,2001,71(6):1765.
[8] Van-de Vaart PJ,Belderbos J,De-Jong D,et al.DNA adduct level as apredictor of outcome for NSCLC patients receiving daily cisplatin and radiontherapy[J].Int J Cancer,2000,89(2):160.
[9] 张连美,仲纪祥,孙苏安.EGFR,ALK和Ki-67在非小细胞肺癌中的表达及相关分析[J].临床肺科杂志,2017,22(1):4.
[10] 张煜坤,戈伟.Ki-67与非小细胞肺癌患者EGFR突变的关系及其对预后的影响[J].中国医药导报,2017,14(32):79.
[11] 姚林军,杜彦丹,李英智,等.肿瘤标志物在肺癌检验中的临床应用分析[J].吉林医学,2014,35(5):997.