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目的探讨细胞质胸苷激酶1(cytoplasmic thymidinekinas-1,TK1)、Ki-67在卵巢浆液性腺癌中表达的意义。方法回顾性研究55例经手术治疗的卵巢浆液性腺癌患者的临床病理资料,并运用免疫组化技术观察TK1、Ki-67在卵巢浆液性腺癌中的表达情况及与临床病理参数之间的意义。结果 TK1阳性表达定位于细胞质,阳性率为72.7%。TK1的表达与肿瘤的最大径、复发、pTNM分期、病理分级密切相关(P<0.05)。Ki-67阳性表达定位于细胞核,阳性率为80.0%,Ki-67的表达与肿瘤的复发、pTNM分期、病理分级有关(P<0.05)。Kappa检验显示TK1的表达与卵巢浆液性腺癌复发较一致(k=0.559,P=0.000),且判断复发比Ki-67更为优越。Kaplan-Meier检验显示pTNM分期、肿瘤复发、MDACC分级、Ki-67、TK1表达分别与预后有关(P<0.05)。COX回归多因素分析显示:肿瘤复发是影响卵巢浆液性腺癌患者的独立性预后因素。结论卵巢浆液性腺癌的复发影响患者的预后,TK1对判断卵巢浆液性腺癌是否有复发倾向具有参考价值,且优于Ki-67,初次手术后肿瘤组织免疫组化TK1高表达预示患者存在高复发的风险,提示临床要加强术后的治疗方案,并提高随访频数。
Objective To investigate the expression of cytoplasmic thymidine kinase-1 (TK1) and Ki-67 in ovarian serous adenocarcinoma. Methods The clinical and pathological data of 55 surgically treated patients with ovarian serous adenocarcinoma were retrospectively studied. The expressions of TK1 and Ki-67 in ovarian serous adenocarcinoma were detected by immunohistochemistry and their correlation with clinicopathological parameters . Results The positive expression of TK1 localized in the cytoplasm, the positive rate was 72.7%. The expression of TK1 was closely related to the maximum diameter, recurrence, pTNM stage and pathological grade (P <0.05). The positive expression of Ki-67 localized in the nucleus, the positive rate was 80.0%. The expression of Ki-67 was correlated with tumor recurrence, pTNM stage and pathological grade (P <0.05). Kappa test showed that the expression of TK1 was more consistent with the recurrence of ovarian serous adenocarcinoma (k = 0.559, P = 0.000), and the prognosis was superior to that of Ki-67. Kaplan-Meier test showed that pTNM staging, tumor recurrence, MDACC grade, Ki-67, TK1 expression were related to prognosis (P <0.05). COX regression multivariate analysis showed that tumor recurrence was an independent predictor of prognosis in patients with ovarian serous adenocarcinoma. Conclusions The recurrence of ovarian serous adenocarcinoma affects the prognosis of patients. TK1 is valuable in judging the recurrence of ovarian serous adenocarcinoma, and is superior to Ki-67. The high expression of TK1 in the immunohistochemical tissue after initial surgery predicts high recurrence The risk, suggesting that the clinical treatment to strengthen the postoperative program, and increase the frequency of follow-up.