肺磨玻璃结节中ki-67的表达及与P53,EGFR,CEA相关性研究

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,P0.001)、0.227(EGFR,P=0.024)、0.441(CEA,P0.001)。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。

The Expression of ki-67 in Ground-glass Opacity (GGO) and its Relation with P53, EGFR, CEA

Objective:To explore the expression of ki-67 in the GGO of different pathology and try to find whether the correlation of ki-67 with P53, EGFR and CEA.Methods:The clinical history, CT information, white blood cell count and pathology material of 254 cases with GGO during 2012 and 2014 were collected and analyzed retrospectively.Results:The expression level of ki-67 was gradually increased fromBenign group (n=66), AAH (n=27), AIS (n=11), MIA (n=108), to IAC (n=42) , which is exactly the evolution progression of early lung adenocarcinoma; The correlation coefficient were 0.386 (p53, P<0.001), 0.227(EGFR, P=0.024) and 0.441 (CEA, P<0.001) respectively; By ROC curve analysis, we got the AUC and optimal cut-off points of ki-67 with regarding to differentiation of GGO and the variation of thresholds along the progression of early lung adenocarcinoma; The number and the percentage of blood monocyte of the patients with malignant GGO were lower than these of benign group.Conclusion:There are significant differences among GGOs of different pathologic categories with respect to the expression of ki-67 that gradually increased in the early lung adenocarcinoma progression. To some extent, a positive correlation of ki-67 with P53, EGFR and CEA exists.