Gli-2 在胸腺肿瘤组织中的表达及其与Ki-67的关系

目的：探讨Gli- 2 蛋白和核增殖标志物Ki-67与胸腺肿瘤的临床病理特征及预后的关系。方法：采用免疫组织化学方法，检测64例胸腺肿瘤（9 例A 型、6 例AB型、11例B 1 型、22例B 2 型及16例C 型）组织中Gli- 2 及Ki-67蛋白的表达情况。结果：1）Gli- 2 在胸腺瘤A 、AB、B 1、B 2、C 型的阳性率分别为1/ 9（11.11%）、2/ 6（33.33%）、2/ 11（18.18%）、5/ 22（22.73%）、13/ 16（81.25%），表达差异有统计学意义（P < 0.05）；Gli- 2 阳性率在Masaoka分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期中分别为2/ 10（20%）、12/ 41（29.27%）、4/ 6（66.67%）、5/7（71.43%），表达差异有统计学意义（P < 0.05）；2）患者肿瘤组织中Gli- 2 的高表达与性别、年龄、出血坏死及合并重症肌无力（myasthenia gravis,MG ）无相关性，但与肿瘤是否侵及胸膜密切相关；3）Ki-67在侵袭性胸腺瘤与非侵袭性胸腺瘤中的阳性标记指数
（LI ）分别为7.14± 6.99、15.24± 9.13，差异具有明显统计学意义（P < 0.05），Ki-67在胸腺瘤中的表达与Gli- 2 的表达呈正相关（r s =0.529，P < 0.05）；4）Gli- 2 阳性组患者5 年无进展生存率（PFS）56.5%（13/ 23）较阴性组的5 年无进展生存率92.7%（38/ 41）低，Ki-67阳性组的胸腺肿瘤患者5 年无进展生存率61.5%（16/ 26）也较阴性组的5 年无进展生存率92.1%（35/ 38）低，且差异具有统计学意义（P < 0.05）。 Cox 比例风险回归模型分析结果显示，Gli- 2 阳性、Ki-67阳性、有胸膜侵袭是影响胸腺肿瘤患者预后的独立危险因素。结论：Gli- 2 与Ki-67在胸腺肿瘤组织中的表达呈正相关，检测二者的表达对判断胸腺肿瘤患者的临床特征及预后有一定提
示作用。

Gli- 2 expression in thymic tumor tissues and its relationship with Ki-67

Objective:To investigate the expression of Gli- 2 protein and nuclear proliferation marker Ki- 67in human thymic tu -mors, as well as its relationship with clinicopathological features and prognosis. Methods:Immunohistochemical staining was per-formed to determine the expressions of Gli- 2 and Ki-67in 64thymic tumor cases, in which 9 were type A,6 were type AB, 11 were type B 1, 22were type B 2, and 16were type C.Results: 1) Positive expression rates of Gli- 2 in types A, AB, B1, B2, and C thymomas were 1/9 (11 .11 %),2/6 (33.33%),2/11 (18.18%),5/22(22.73%), and13/16(81.25%), respectively. Statistically significant differences
existed in the two sets of data (P<0.05). Positive rates of Gli- 2 in the Masaoka stages Ⅰ, Ⅱ, Ⅲ, and Ⅳwere 2/10(20% ), 12/41 (29.27%),4/6 (66.67%), and5/7 (71.43%), respectively. The statistical differences of these two sets of data were also significant (P< 0.05). 2) The expression levels of Gli- 2 in tumor tissues were closely correlated with the pleura (P<0.05) but not associated with gen -der, age, myasthenia gravis, and necrosis with hemorrhage (P>0.05). 3) The positive labeling indexes of Ki-67in invasive and non-inva -sive thymomas were 7.14± 6.99and 15.24± 9.13, respectively. The differences between both thymomas were statistically significant (P<0.05). 4) A positive correlation existed in the expression of Ki-67and Gli-2 in thymomas. Five-year progression-free survival (PFS) rate was lower in the Gli- 2 positive group (56.5%,13/23) than in the negative group ( 92.7%,38/41). The Ki-67-positive group ( 61.5%, 16/26) also showed a lower five-year PFS than that in the negative group ( 92.1%,35/38), with statistically significant differences be-tween the two groups ( P<0.05). Multivariate Cox's proportional hazard regression analysis indicated that the Gli- 2-positive group ex -pression, Ki-67-positive group expression, and invasion of the pleura were independent prognostic factors of thymic tumors. Conclu-sion:The expression of Gli-2 and Ki-67showed a positive correlation with thymic tumors. Detecting the combined expression of Gli- 2 and Ki-67may elucidate the clinicopathological features and prognoses of patients with thymic tumors.