Shane Mesko, Patrick Kupelian, D Jeffrey Demanes, Jaoti Huang, Pin-Chieh Wang, Mitchell Kamrava
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引用次数: 20
摘要
背景:Ki-67是前列腺癌强有力的预测/预后指标;然而，前列腺活检样本中的肿瘤异质性尚未得到很好的研究。方法:使用MRI/US融合装置，系统地获得活检芯，并在MRI指示时靶向。对连续77名男性的前列腺癌核心进行了分析。Ki-67最高值用于测定前列腺间变异。Ki-67范围(最高减去最低)用于确定前列腺内和病变内的变异。测定表观扩散系数(ADC)与Ki-67的关系。结果:NCCN低(L)、中(I)、高(H)危患者的前列腺间Ki-67均值±标准差(SD)值分别为5.1±3.8%、7.4±6.8%、12.0±12.4% (ANOVA P = 0.013)。L、I、H危患者前列腺内Ki-67均值±SD分别为2.6±3.6%、5.3±6.8%、10.9±12.3% (ANOVA P = 0.027)。L、I、H危患者病灶内Ki-67均值±SD分别为1.1±0.9%、5.2±7.9%、8.1±10.8% (ANOVA P = 0.22)。结论:高危患者前列腺间和前列腺内Ki-67异质性显著增高。在临床应用Ki-67时需要考虑到这一点。
Quantifying the ki-67 heterogeneity profile in prostate cancer.
Background: Ki-67 is a robust predictive/prognostic marker in prostate cancer; however, tumor heterogeneity in prostate biopsy samples is not well studied.
Methods: Using an MRI/US fusion device, biopsy cores were obtained systematically and by targeting when indicated by MRI. Prostate cores containing cancer from 77 consecutive men were analyzed. The highest Ki-67 was used to determine interprostatic variation. Ki-67 range (highest minus lowest) was used to determine intraprostatic and intralesion variation. Apparent diffusion coefficient (ADC) values were evaluated in relation to Ki-67.
Results: Interprostatic Ki-67 mean ± standard deviation (SD) values for NCCN low (L), intermediate (I), and high (H) risk patients were 5.1 ± 3.8%, 7.4 ± 6.8%, and 12.0 ± 12.4% (ANOVA P = 0.013). Intraprostatic mean ± SD Ki-67 ranges in L, I, and H risk patients were 2.6 ± 3.6%, 5.3 ± 6.8%, and 10.9 ± 12.3% (ANOVA P = 0.027). Intralesion mean ± SD Ki-67 ranges in L, I, and H risk patients were 1.1 ± 0.9%, 5.2 ± 7.9%, and 8.1 ± 10.8% (ANOVA P = 0.22). ADC values at Ki-67 > and <7.1% were 860 ± 203 and 1036 ± 217, respectively (P = 0.0029).
Conclusions: High risk patients have significantly higher inter- and intraprostatic Ki-67 heterogeneity. This needs to be considered when utilizing Ki-67 clinically.
期刊介绍：
Prostate Cancer is a peer-reviewed, Open Access journal that provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. The journal publishes original research articles, review articles, and clinical studies related to the diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.
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