Expression Of Ki-67 And Its Clinical Significance In Cervical Carcinoma

Objective: To investigate the expression of proliferating cell nuclear antigen (Ki-67) in tissues of normal cervical epithelia (NCE), cervical intraepithelial neoplasm (CIN) and invasive cervix carcinoma (ICC), combined with the different adjuvant therapies in patients of early-stage cervical cancer after operation, and determine the relationship between Ki-67 and recurrence and prognosis of cervical cancer. Methods: Expression of Ki-67 was immunohistochemically detected in 150 cases of NCE, 200 cases of CIN and 500 cases of ICC. The relationship between the expression and the recurrence and prognosis of cervical carcinoma patients was analyzed statistically,combined with clinical follow-up data. In 156 postoperative patients with stage ?B1?? A cervical squamous cell carcinoma, 94 patients accepted radiotherapy and 62 patients accepted chemoradiotherapy. The expression of Ki-67 was detected by immunohistochemistry at diagnosis. In case of different Ki-67 expressions, the relationship of disease-free survival (DFS), overall survival (OS) with two adjuvant treatment schemes were analyzed by statistics.Results: The expression rates of Ki-67 > 1010% were 19.3% , 44.5% and 78.6% in the tissues of NCE, CIN, ICC, respectively (P<0.05). Logistic regression and cox regression showed that advanced stage of the disease, lymphatic metastasis, Ki-67 overexpression and low differentiation were all related factors with recurrence of patients. The clinical stages, lymphatic metastasis, age and the expression of Ki-67 were all related factors with prognosis of cervical carcinoma. In 98 cases of early-stage cervical cancer with Ki-67 > 10%, the median of DFS and OS were 65.0 months (95% confidence internal:63.8 ? 72.6 months) and 66.0 months (95% confidence internal:64.3 ? 73.1 months). For those accepted radiotherapy and chemoradiotherapy, the median of DFS were 60.0 months (95% confidence internal:49.2 ? 85.0 months) and 91.0 months(95% confidence internal:86.2 ? 91.0 months) (P =0.032), and the median of OS were 62.0 months (95% confidence internal:49.8 ? 58.7 months) and 92.0 months (95% confidence internal:86.4 ? 91.4 months) (P =0.038). In 58 cases of early-stage cervical cancer with Ki-67 ? 100/% the median of DFS and OS were 72.0 months (95% confidence internal:54.7 ? 89.3 months) and 75.0 months (95% confidence internal:59.0 ? 91.0 months), and the median of DFS and OS between radiotherapy and chemoradiotherapy had no statistic significance (P>0.05). Conclusions: In early-stage cervical cancer after operation, the survival of chemoradiotherapy is superior to radiotherapy in Ki-67 > 10% patients. Whether the expression of Ki-67 after operation can be used as a screening index to choose the postoperative adjuvant therapy of patients with early-stage uterine cervical cancer still needs to be determined.Ki-67 may be one of recurrence and prognosis factors for cervical cancer, but the relationship of them needs further validation.