Ki-67在胸腹水的液基薄层细胞涂片中表达及意义

  目的  细胞增殖抗原标记物（Ki-67）为细胞增殖的一个重要生物学指标, 本研究旨在探讨Ki-67在良、恶性胸腹水的液基细胞涂片中的表达差异及其临床意义。  方法  本实验收集恶性胸腹水标本49例作为恶性组, 良性胸腹水标本25例作为良性组。用液基薄层细胞学检查（thin-layer cytology test, TCT）法对所有标本进行制片后, 采用免疫组织化学染色法检测恶性组和良性组的涂片中Ki-67蛋白的表达, 在光学显微镜下观察并利用图像分析系统进行半定量分析。  结果  恶性组Ki-67表达的阳性率明显高于良性胸腹水组（P < 0.01）; 恶性组Ki-67阳性细胞平均标记指数（MLI）高于良性组（P < 0.05）; 恶性组Ki-67蛋白表达的相对含量明显高于良性组, 两组相比有显著性差异（P < 0.01）。恶性组与良性组Ki-67表达分析显示两组间在性别、年龄、病史方面无显著性差异（P>0.05）。  结论  Ki-67可作为恶性胸腹水诊断的一个新的生物标记物, 对鉴别良、恶性胸腹水有一定的参考价值。利用TCT方法, 有利于提高细胞制片质量, 便于胸腹水性质的判断。 

Determination of Ki-67 Expression and Its Significance in Cell Smears of Pleural Effusion and Ascites using Thin-layer Cytology Test

  Objective  This study aims to investigate the expression and significance of Ki-67 in their cell smears of pleural effusion and ascites, using the thin-layer cytology test.  Methods  This study involved 49 and 25 cases of malignant and benign pleural and peritoneal effusions, respectively. Immunohistochemical staining method was used to detect Ki-67 expression in the cell smears of both malignant and benign groups after all samples underwent cell smearing via thin-layer cytology test under an optical microscope. Semi-quantitative analysis was performed using an image analysis system.  Results  The antigen expression of Ki-67 positive cells of the malignant group was significantly higher than that of the benign group (P < 0.01). Moreover, the MLI of Ki-67 in the malignant group was higher than that in the benign group (P < 0.05). The relative protein content of the Ki-67 positive cells in the malignant group was also significantly higher than that in the benign group (P < 0.01). However, the Ki-67 expression in both groups were not significantly different in terms of gender, age, and illness history (P > 0.05).  Conclusion  The Ki-67 expression in pleural effusion and ascites can be used as a new biomarker in the early diagnosis of malignant pleuroperitoneal effusions. The results of this study can help identify the clinical nature of pleural effusion and ascites. Thin-layer cytology test is also a convenient and effective method for identifying malignant pleural effusion and ascites.