p53突变型乳腺癌中Ki67表达水平的临床意义

目的：探讨乳腺癌组织中p53的突变情况及Ki67的表达水平，明确p53与Ki67联合作用在乳腺癌临床病理因素上的体现。方法：应用免疫组化SP法检测165例乳腺癌组织中p53、Ki67的表达，分析其与临床病理因素之间的关系。结果：p53的突变率为55.8%（92/165），Ki67的阳性表达率为69.1% （114/165）。p53的突变情况与患者年龄、肿块大小、淋巴结转移、TNM分期、ER和PR的表达水平无关，但与HER-2的表达水平呈正相关。在总人群中Ki67的表达水平与肿块大小和淋巴结转移无关。亚组分析显示在p53突变的患者中，Ki67的表达水平与肿块的大小呈正相关（r=0.311，P=0.003），与淋巴结转移呈正相关（r=0.342，P=0.001）。结论：在p53突变型乳腺癌中Ki67的表达与T分期及N分期均呈正相关，在p53突变人群中Ki67对乳腺癌的生物学行为和患者的预后可能有更高的预测价值，二者联合检测与解读可能更有助于判断乳腺癌患者的预后。

Clinical significance of Ki67 in p53 mutation - positive breast cancer

Objective：To investigate the mutation status of p53 and the expression of Ki67,and explore the clinical significance of their combined effect in breast cancer.Methods：To detect the expression of p53 and Ki67 using immunohistochemical SP method in 165 cases of breast cancer.Results：p53 mutation rate was 55.8% （92/165）.The positive expression rate of Ki67 was 69.1% （114/165）.The status of p53 had no significant correlation with age,tumor size,lymph nodes metastases,TNM stage,ER and PR expression,but had a positive correlation with Her-2 expression.In the general population,the expression of Ki67 had no significant correlation with tumor size and lymph nodes metastases.Subgroup analysis showed that Ki67 had a positive correlation with tumor size and lymph nodes metastases in p53 mutation-positive patients.Conclusion：Ki67 had a positive correlation with tumor size and lymph node metastases in p53 mutation-positive patients.Ki67 might be an important predictor of biologic behavior and prognosis in p53 mutation-positive breast cancer.The prognostic model that combined p53 and Ki67 might be more valuable in breast cancer.