Ki67 在HBV 相关肝细胞癌病理组织中的表达及其临床意义

目的探讨细胞核增殖抗原Ki67 在乙型肝炎病毒（HBV）相关肝细胞癌（HCC）病理组织中的表达及其与临床病理指标的关联性。方法134 例HBV 相关HCC 患者按Ki67 阳性细胞所占百分数（Ki67 指数）分为Ki67 指数＜10%（阴性）组30 例和≥10％（阳性）组104 例。采用免疫组化法检测Ki67 在正常及不同分化程度肝组织中的表达情况。分别计算2 组Ki67 指数与年龄、性别、磷脂酰肌醇蛋白3(GPC3)、组织学分级、BCLC 分期、门脉转移、甲胎蛋白（AFP）、肝功能Child-pugh 分级资料的相关性。依Ki67 指数区间设定评分以评估Ki67 评分与BCLC 分级的关系。结果（1）SP 染色结果显示，Ki67 在正常肝组织、高分化、中分化及低分化组织中的表达强度呈增加趋势。（2）阳性组Ki67 指数与BCLC 分期、门脉转移、组织学分级、GPC3、AFP 及Child-pugh 分级呈正相关（P＜0.05）；阴性组Ki67 指数与各临床指标均无相关性（P > 0.05）。（3）Ki67 评分随着BCLC 分级的进展呈增加趋势。结论阳性组Ki67 指数联合患者的GPC3、组织学分级、BCLC 分期、门脉转移、AFP、肝功能Child-pugh 分级可评估患者HCC 的严重程度，其表达水平有望成为HBV 相关HCC 早期诊断、晚期预后评估的重要指标。

Expression of Ki67 and its clinic significance in HBV related hepatocellular carcinoma

Objective To investigate the expression of proliferating cell nuclear antigen (Ki67) in hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) tissue and its correlation with clinicopathological parameters of HBV related HCC. Methods HBV-related HCC patients (n=134) were divided according to Ki67 index (the percentage of Ki67-posi⁃ tive cells) into Ki67 index <10% group (negative group, n=30) and Ki67 index ≥10% group(positive group, n=104). The cor⁃ relation of Ki67 index with age, gender, glypican 3 (GPC3), histological grade, BCLC (Barcelona Clinic liver cancer) staging, portal involvement, AFP (AFP), liver function related child-pugh classification data were calculated in both groups. Ki67 in⁃ dex is set according to the interval score to assess the relationship between Ki67 score and BCLC classification. Results (1) SP staining showed, Ki67 present a trend of increase from normal liver tissue to well-differentiated to medium differentiat⁃ ed tissue to poorly differentiated tissues intensity. (2) In positive group, Ki67 index was correlated with BCLC staging, portal metastasis, histological grade, GPC3 and AFP (P < 0.05); By contrast, in negative group, Ki67 index was not correlated with any clinical parameter (P > 0.05). (3) Ki67 score increases with the progress of BCLC classification. Conclusion In Ki67 positive group, Ki67 index combined with GPC3, histological grade, BCLC staging, portal involvement, AFP and liver func⁃ tion child-pugh classification can assess the severity of the patients with HCC, which is expected to become an important in⁃ dicator for the HBV-related HCC early diagnosis.