Ki-67、p16和CK34βE12蛋白对可手术宫颈癌患者的预后价值

摘要

Objective:To discuss the prognostic value of Ki-67,p16,CK34βE12 antigen,pathological features and postoperative adjuvant treatment on the operable cervical cancer patients.Methods:The expression of Ki-67,p16,CK34βE12 in 72 cases of postoperative cervical carcinoma was detected by immunohistochemistry to follow up the PFS,combining with pathological features and treatment of patients,ending with the progression of disease.Univariate factors were analyzed by Kaplan-Meier method,Multiple factors were analyzed by Cox regression analysis.Results:Univariate analysis showed that Ki-67 (P =0.006),CK34βE12 (P =0.007),the production situation (P =0.018),menopausal status (P =0.008),nationality (P =0.034),pain situation (P =0.008),tumor FIGO stage (P =0.000),tumor size (P =0.015),lymph node metastasis (P =0.000) and chemotherapy (P =0.016) related to the patients prognosis.Cox multivariate analysis showed the expression of Ki-67,age,maternity,menopausal status,degree of differentiation,depth of myometrial invasion,violations along the uterus,radiotherapy can effect the PFS (P＜ 0.05).However,the expression of p16 and CK34βE12 patient antigen,tumor size,differenrtiated degree,age at menarche,nationality,occupation,surgery and chemotherapy had no significant effect on PFS (P ＞ 0.05),not yet as independent prognostic factors.Conclusion:Ki-67 high expression,young,premature delivery,late tumor stage,deep grass roots and violations along the uterus,and the radiotherapy are the independent prognostic factors of cervical cancer.Expression of p16 and CK34βE12 antigens,tumor size,degree of differentiation,age at menarche,nationality,occupation,surgery and chemotherapy are related to the prognosis only,not yet as an independent prognostic factor.%目的:探讨Ki-67、p16、CK34βE12蛋白、患者病理特征及术后辅助治疗方式对可手术的宫颈癌患者的预后价值.方法:采用免疫组化法检测72例宫颈癌术后病理组织中Ki-67、p16、CK34βE12蛋白的表达,结合患者病理特征及治疗方式,以患者疾病进展为研究终点,随访截止至2016年10月.单因素分析采用Kaplan-Meier法,多因素分析采用Cox回归分析.结果:单因素分析显示:Ki-67(P =0.006)、CK34βE12(P=0.007)、生产次数(P=0.018)、绝经情况(P =0.008)、民族(P =0.034)、有无疼痛(P =0.008)、肿瘤分期(P =0.000)、肿瘤大小(P =0.015)、淋巴结转移情况(P =0.000)、化疗情况(P =0.016)与患者预后相关.Cox分析结果显示:宫颈癌患者的Ki-67表达情况、发病年龄、怀孕次数、生产情况、绝经情况、肿瘤分期、是否深肌层受到侵犯、是否沿子宫侵犯、是否放疗是影响可手术宫颈癌患者PFS的显著性因素(P＜0.05).而患者p16和CK34βE12蛋白的表达、肿瘤大小、分化程度、初潮年龄、民族、职业、手术和化疗情况等对PFS无明显影响(P＞0.05),尚不能作为独立的预后因素.结论:Ki-67的高表达、低龄、早产、肿瘤分期晚、深肌层及沿子宫受侵犯、放射治疗均为宫颈癌的独立预后因素;p16和CK34βE12蛋白的表达、肿瘤大小、分化程度、初潮年龄、民族、职业、手术和化疗情况仅与预后相关,尚不能作为独立的预后因素.