| Objective To study the expression of cell proliferation marker Ki-67 in locally advanced(IIB stage) cervical cancer and explore the relationship between Ki-67 with histopathological characteristics.Also study on the relationship between Ki-67 and disease-free survival(DFS) or overall survival(OS) in patients that suffer from locally advanced(IIB stage)cervical cancer. Hoping to have further understanding of the disease characteristics and prognosis by Ki-67. To find a more perfect treatment and improve the prognosis.Methods Collection the data of inpatients who visited at the Department of gynaecology of the First Affiliated Hospital of Chongqing Medical University in 2012 and newly diagnosed with locally advanced cervical cancer(according to FIGO staging were IIB period). After 1 to 3times of new adjuvant chemotherapy, suitable for operation and the surgery of extensive hysterectomy and pelvic lymph node dissection were performed between January 1st and December 31 st,in 2012. A total of 42 patients with stage IIB cervical cancer were collected and patients were followed up for at least 1 times. Collect possible factors that may affect the survival of patients. Re-slice the pathological samples and determine the expression of Ki-67 in tumor tissues by immunohistochemical staining.According to different needs, the chi-square test, non parametric test,Spearman rank correlation analysis were used for analysis the relationship between Ki-67 and age, pathological characteristics.Survival analysis was performed by using Kaplan- Meier product- limit method and the Cox proportional hazards model。Results1. The 1-year, 2-year and 3-year DFS of the whole group of 42 patients is 95.2%, 85.7% and 85.7%.Average time of DFS is 37 months, the median time of DFS is 40 months; 1-year,2-year and 3-year OS is 97.6%, 95.2% and 92.8%.2. The positive expression rate of Ki-67 is 95.2%, 40 cases of positive expression of Ki67 and 2 cases of negative expression.No significant relationship between Ki-67 and the patient’s age or pathological characteristics had been found.3. The Ki-67 was divided into three groups:Ki-67-(<10%), Ki-67+(10%-50%), Ki-67 ++(50%-100%), survival analyzes were performed, and the Log-Rank test was used between different groups. The result shows that between different Ki-67 expression group the diease-free survival is different(P =0.008 <0.05). The higher ki67 positive rate is, the shorter of disease-free survival; however there is no significant difference between Ki-67 expression and Overall survival.4. COX univariate analysis of DFS showed that vascular invasion,tumor invasion range, Ki-67 expression rate are the three factors that influence the DFS of cervical cancer patients(P<0.05); COX multivariate analysis of DFS: tumor invasion range, Ki-67 expression rate are the independent prognostic factors of stage IIB cervical cancer patients’ DFS(P <0.05).5. COX univariate analysis on OS showed that Lymph node-positive is a bad prognostic factors for overall survival(P= 0.044). COX multivariate analysis on OS found no independent prognostic factor of OS in stage IIB cervical cancer patients(P> 0.05). Conclusion1 Ki-67 expression was high in patients with stage IIB cervical cancer, but the relationship between Ki-67 with age, tumor grade,lymph node metastasis, vascular invasion, etc was still unclear.2 IIB cervical cancer patients in different Ki-67 expression had different DFS, the higher the Ki-67-positive rate, the shorter of DFS.Different Ki-67 expression had no significant effect on OS.3 Tumor invasion range, Ki-67 expression rate were the two independent prognostic factors of DFS in stage IIB cervical cancer patients(P <0.05).4. After the survival analysis of stage IIB cervical cancer patients’ prognosis by Ki-67, basically clear that Ki-67 is one of the negative prognostic factors of IIB cervical cancer patients. |
PDF Full Text Request