细胞核相关抗原（Ki67）和p53 表达 对非小细胞肺癌患者预后的意义

目的 检测非小细胞肺癌患者肿瘤组织中细胞核相关抗原Ki-67（Ki67）和p53 的表达水平，探 讨其对患者预后（生存率）判断的意义。方法 用免疫组织化学染色半定量检测非小细胞肺癌患者肿瘤组织 中的Ki67 和p53 表达水平。对患者进行随访，分析Ki67 和p53 表达水平与患者生存时间和生存率的关系。 结果 相关性分析结果表明，Ki67 阳性细胞率与非小细胞肺癌患者生存时间具有较弱的相关性（r =-0.200， P =0.030），p53 阳性细胞率与非小细胞肺癌患者生存时间无相关性（r =0.003，P =0.050）。单因素分析结果提示， Ki67 和p53 共表达以及原发肿瘤局部淋巴结远处转移（TNM）分期对患者生存期有影响，差异有统计学意义 （P =0.000）。当Ki67 和p53 均低表达时，患者的中位生存时间及1 ～ 5 年生存率均高于平均水平。预后影响因 素Cox 回归分析表明，TNM 分期越低，患者中位生存时间越长，死亡风险越低。结论 TNM 分期是影响肺癌 预后的指标，TNM 分期越高，患者死亡风险越大。Ki67 和p53 均低表达时，中位生存时间及1 ～ 5 年生存率 均高于平均水平，提示Ki67 和p53 联合检测可为非小细胞肺癌早期诊断及预后判断提供辅助依据。

Prognostic significance of Ki67 and p53 in non-small cell lung cancer patients

Objective To investigate the expression of nuclear-associated antigen ki-67 (Ki67) and p53 in nonsmall cell lung cancer (NSCLC) patientsand their association with prognosis. Methods Immunohistochemistry (IHC) semi-quantitative method was utilizedfor expression of Ki67 and p53 in tumor tissues. Patients were divided into 4 groups based on expression levels of Ki67 and p53: group A in which both Ki67 and p53 were highly expressed; group B in which Ki67 was highly expressed and p53 was lowly expressed; group C in which Ki67 was lowly expressed and p53 was highly expressed; group D in which both Ki67 and p53 were lowly expressed. Correlation of Ki67 and p53 expression with survival was identified. Results Week correlation between Ki67 positive rate and survival time of NSCLC patients was identified (r = -0.200, P = 0.030) while no correlation between p53 positive rate and survival time of NSCLC patients (r = 0.003, P = 0.050) was founded. Univariate analysis showed that coexpression of Ki67 and p53, and tumor node metastasis (TNM) staging had significant impact on the survival of patients (P = 0.000). Median survival time and 1 to 5-year survival rates of patients was increased significantly in patients with low expression of Ki67 and p53 (group D). Cox regression analysis showed that lower TNM staging indicated prolonged median survival time and lower the risk of death. Conclusion Lower TNM staging and double negative expression of Ki67 and p53 suggest better outcome of patients with NSCLC.