Ki-67蛋白在原发性骨恶性肿瘤侵袭性中的预测作用。回顾性研究

Ioan-Mihai Japie, D. Rădulescu, A. Bădilă, A. Papuc, T. Ciobanu, A. Dumitru, C. Cirstoiu
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Patients repartition according to diagnosis was the following: 21 patients with osteosarcoma, 18 patients with chondrosarcoma, 6 patients with Ewing sarcoma, 3 patients with malignant fibrous histiocytoma, and 2 with fibrosarcoma. The follow-up period was between 12 and 72 months with a mean of 26 months. Results: Patients were aged between 18 and 77 years old, with a mean age of 41,36. There were 22 women and 28 men. No sex or age difference was notable for the tumor outcome. After calculating the Ki-67 LI, 36 patients were included in the high-risk group (Ki-67 LI > 25%), while 14 had a low risk for metastasis and local relapse (Ki-67 < 25%). The low-risk patients had chondrosarcoma (8 patients), osteosarcoma (5 patients), and fibrosarcoma (1 patient). During the follow-up, 8 patients, all belonging to the high risk group, developed metastasis, while 5 patients developed local recurrences; 4 patients who relapsed belonged to the high risk group and 1 to the low risk group. 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摘要

摘要:为了诊断和分期恶性骨肿瘤,有必要对骨标本进行免疫组化病理检查;它们还提供有关中长期预后的信息。在具有潜在预测价值的组织生物标志物中,Ki-67蛋白水平升高可用于确定局部复发或转移的风险。材料和方法:本研究对布加勒斯特大学急救医院创伤骨科收治的50例原发性恶性骨肿瘤患者进行了研究。根据诊断重新划分的患者如下:骨肉瘤21例,软骨肉瘤18例,尤文氏肉瘤6例,恶性纤维组织细胞瘤3例,纤维肉瘤2例。随访12 ~ 72个月,平均26个月。结果:患者年龄18 ~ 77岁,平均年龄41,36岁。有22名女性和28名男性。肿瘤预后无性别或年龄差异。计算Ki-67 LI后,36例患者属于高危组(Ki-67 LI > 25%), 14例患者转移和局部复发风险低(Ki-67 < 25%)。低危患者为软骨肉瘤(8例)、骨肉瘤(5例)、纤维肉瘤(1例)。随访期间,8例患者发生转移,5例局部复发,均属于高危组;4例复发患者属于高危组,1例属于低危组。3例骨肉瘤、2例尤文氏肉瘤、2例软骨肉瘤和1例纤维肉瘤发生转移。大多数转移发生在手术后一年内。1例纤维肉瘤患者6个月后出现局部复发,2例骨肉瘤患者出现局部复发,1例尤文氏肉瘤和软骨肉瘤患者出现局部复发。结论:虽然Ki-67 LI值在确定原发性骨恶性肿瘤的侵袭性方面是有用的,但为了准确预测患者的预后,它应该与临床、影像学和解剖病理学诊断方法结合使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The predictive role of Ki-67 protein in determining the aggressiveness of primary malignant bone tumors. A retrospective study
Abstract Introduction: In order to diagnose and stage malignant bone tumors, the pathologic examination of harvested pieces with immunohistochemistry test is necessary; they also provide information regarding the prognosis on a medium to long term. Among tissular biomarkers with potential predictive value, a raised Ki-67 protein level is used to determine the risk of local recurrence or metastasis. Material and method: This study was performed on 50 patients with primary malignant bone tumors admitted in the Traumatology and Orthopedy Department of University Emergency Hospital, Bucharest. Patients repartition according to diagnosis was the following: 21 patients with osteosarcoma, 18 patients with chondrosarcoma, 6 patients with Ewing sarcoma, 3 patients with malignant fibrous histiocytoma, and 2 with fibrosarcoma. The follow-up period was between 12 and 72 months with a mean of 26 months. Results: Patients were aged between 18 and 77 years old, with a mean age of 41,36. There were 22 women and 28 men. No sex or age difference was notable for the tumor outcome. After calculating the Ki-67 LI, 36 patients were included in the high-risk group (Ki-67 LI > 25%), while 14 had a low risk for metastasis and local relapse (Ki-67 < 25%). The low-risk patients had chondrosarcoma (8 patients), osteosarcoma (5 patients), and fibrosarcoma (1 patient). During the follow-up, 8 patients, all belonging to the high risk group, developed metastasis, while 5 patients developed local recurrences; 4 patients who relapsed belonged to the high risk group and 1 to the low risk group. Metastases developed in 3 patients with osteosarcoma, 2 with Ewing sarcoma, 2 with chondrosarcoma and 1 patient with fibrosarcoma. Most metastases occurred within one year after surgery. The other fibrosarcoma patient developed local recurrence after 6 months, while the other local recurrences occurred in osteosarcoma patients (2 cases) and 1 in a Ewing sarcoma patient and chondrosarcoma patient. Conclusions: Our study concluded that while Ki-67 LI values are useful in determining the aggressivity of primary malignant bone tumors, it should always be used in conjunction with the clinical, imaging and anatomopathological diagnosis methods in order to accurately predict the patients’ outcome.
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