邱柏圣, 杜君, 张艳辉, 王晴, 陈薇, 王坤, 张超, 姚欣. 免疫组织化学指标判断非肌层浸润性膀胱癌分期及病理分级的价值[J]. 中国肿瘤临床, 2018, 45(1): 37-41. DOI: 10.3969/j.issn.1000-8179.2018.01.751
引用本文: 邱柏圣, 杜君, 张艳辉, 王晴, 陈薇, 王坤, 张超, 姚欣. 免疫组织化学指标判断非肌层浸润性膀胱癌分期及病理分级的价值[J]. 中国肿瘤临床, 2018, 45(1): 37-41. DOI: 10.3969/j.issn.1000-8179.2018.01.751
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Qiu Baisheng, Du Jun, Zhang Yanhui, Wang Qing, Chen Wei, Wang Kun, Zhang Chao, Yao Xin. The value of immunohistochemical indicators in staging and grading of non-muscle invasive bladder cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(1): 37-41. DOI: 10.3969/j.issn.1000-8179.2018.01.751
Citation: Qiu Baisheng, Du Jun, Zhang Yanhui, Wang Qing, Chen Wei, Wang Kun, Zhang Chao, Yao Xin. The value of immunohistochemical indicators in staging and grading of non-muscle invasive bladder cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(1): 37-41. DOI: 10.3969/j.issn.1000-8179.2018.01.751
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免疫组织化学指标判断非肌层浸润性膀胱癌分期及病理分级的价值

The value of immunohistochemical indicators in staging and grading of non-muscle invasive bladder cancer

    摘要
  • 摘要:
      目的  探讨Ki-67、TP53、Cyclin D1、HER-2与非肌层浸润性膀胱癌(non-muscle invasive bladder cancer，NMIBC)分期、病理分级的关系。
      方法  回顾性分析2015年1月至2016年12月184例就诊于天津医科大学肿瘤医院行经尿道膀胱肿瘤电切术(transurethral resection of the bladder，TURBT)，术后病理证实为Ta、T1期NMIBC患者的临床病理资料。利用免疫组织化学法检测癌组织中的Ki-67、TP53、Cyclin D1和HER-2表达，并对其与NMIBC分期、病理分级关系进行单因素分析，采用Logistic多因素回归模型分析影响NMIBC分期、病理分级的独立因素，计算并比较其灵敏度及特异度。
      结果  单因素分析显示肿瘤大小与NMIBC的T1期及病理G3级呈正相关(P＜0.05)；NMIBC的T1期及病理G3级组织中的Ki-67、HER-2高表达，与肿瘤分期及病理分级均呈正相关(P＜0.05)；NMIBC的Ta期及病理G1、G2级组织中的Cyclin D1高表达，与肿瘤分期及病理分级呈负相关(P＜0.05)。Logistic多因素分析显示，Ki-67高表达、Cyclin D1低表达为T1期NMIBC的独立预测因素；Ki-67高表达、HER-2高表达、Cyclin D1低表达为病理G3级NMIBC的独立预测因素。在NMIBC组织中Ki-67对预测分期和病理分级均有较高的灵敏度和特异度，灵敏度为81.40% (48/59)和76.80% (96/125)，特异度为76.83% (63/82)和86.30% (88/102)。
      结论  检测Ki-67表达可以更加准确地判断NMIBC分期及病理分级，为及时有效地治疗提供参考依据。

     

    Abstract:
      Objective  To evaluate the staging and grading valut of Ki-67, TP53, Cyclin D1, HER-2 in non-muscle invasive bladder cancer (NMIBC).
      Methods  Retrospective analysis was performed on the clinicopathologic characteristics of 184 Ta, T1 stage NMIBC patients who underwent transurethral resection of the bladder (TURBT) at the Tianjin Medical University Cancer Institute and Hospital from January 2015 to December 2016. The expression of Ki-67, TP53, Cyclin D1 and HER-2 was evaluated by immunohistochemical assay. Then, the association between immunohistochemical indicators expression, staging and grading of NMIBC were assessed by univariate analysis. The independent factors of staging and grading in NMIBC were assessed by multivariate Logistic analysis, and their sensitivity and specificity were compared.
      Results  Univariate analysis showed a positively correlation between tumor size and T1 and G3 of NMIBC (P < 0.05). The high expression of Ki-67 and HER-2 was positively correlated with tumor staging and grading (P < 0.05) in T1, G3 NMIBC tissues. The high expression of CyclinD1 was negatively correlated with tumor staging and grading (P < 0.05) in Ta stage tissues. Logistic multivariate analysis showed that high expression of Ki-67 and low expression of Cyclin D1 were independent predictors of T1 in NMIBC. High expression of Ki-67, high expression of HER-2 and low expression of Cyclin D1 were independent predictors of G3 in NMIBC. The Ki-67 expression had high sensitivity and specificity for predicting tumor staging and grading in NMIBC. The sensitivity were 81.40% (48/59) and 76.80% (96/125), and the specificity were 76.83% (63/82) and 86.30% (88/102), respectively.
      Conclusions  Detection of Ki-67 expression could predict staging and grading in NMIBC, and provide the basis for appropriate treatment.

     

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