The Prognostic Significance Of The Expression Of P27kip1 And Ki-67 In Non-Small Cell Lung Cancer

In order to study the expression of tumor suppressor gene p27kipl and nucleic proliferation related antigen ki-67 in Non Small Cell Lung Cancer(NSCLC), and to study the relationship between thire expression and clinicopa-thological features and the relationship between p27kipl and ki-67 and their impact on prognosis, we checked the expression of p27kipl and ki-67 of tissues surgically removed from 64 cases NSCLC using the method of Immun-ohistochemistry(IHC). Cells have brown granules in their nucleus are taken as positive stained, calculated their percentage of positive stained cells. The expression of p27kipl were regarded as high or low according to their positive percentage being higher or lower than 50% while that of ki-67 being 30%. Analyzed the expression of p27kipl and ki-67 and clinicopathological factor employing T test, and made univariate and multivariate survival analyses using Kaplan-Meier, COX method with medical statistic software SPSS9.0.The results revealed that the mean marker of p27kipl of lung cancer tissue were 42.39%, among them high expression 27 cases (42.2%), low expression 37 cases (57.8%). The declining of the expression of p27kipl were closely related to histological grade(p<0. 05) lymphnode metastasis(p<0.01) high tumor proliferation activity (p<0.001), were not related to tumor size and pathological type(p>0.05). Low expression of ki-67 40 cases (62. 5%) , hi gh express ion 24 cases (37. 5%) . High ki-67 marker were related to lymph node metastasis(p<0.05). There was a obvious negative mutuality between p27kipl and ki-67 (r=-0.427 p<0.001). Kaplan-Meier survival analysis showed that the median survival time of patients with high p27kipl expression was 43 months, those of low p27kipl expressin 12 months (p<0.01); median survival time of patients with low ki-67 expression was 40 months while 10 months of high ki-67 expression (p<0.01) ; median sruvival time of the positive group of lymph node metastasis was 12 months, 36 months of the negative group (p<0.05).In the prognostic estimation by p27kipl combined with ki-67, the situation of patients with high ki-67/low p27 progressed rapidly, had a short survival time; the survival tiem of those with lowki-67/high p27 expression prolonged obviously. The COX univariate sruvival analyses showed that p27kipl, ki-67, histological grade, lymph node metastasis has statistic importance, in multivariate analyses only p27kipl, ki-67, lymph node metastasis were independent prognostic fectors.This research has such conclusion, as a tumor supressor gene, p27kipl is obviously negative related to ki-67 which represents cellular proliferative activities (r=-0.472 p<0.001), indicated that the decline of p27kipl protein promotes or reflects the proliferation of NSCLCcells, high p27kipl expression suppresses the proliferation or progress of tumor. Lymph node metastasis, p27kipl, ki-67 can be used to make prognosis. It is more valuable combining p27kipl and ki-67 to make prognosis and select auxiliary treatment measures after curative resection. So, the researches about the expression of proteins p27kipl, ki-67 may divide NSCLC patients after curative resection into high danger group and low danger group, thereby indicate which patients need further treatments.