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目的:探讨食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)组织中p16与Ki-67表达,分析其与临床病理特征及预后相关性。方法:采用免疫组织化学SP法检测63例术后ESCC组织中p16与Ki-67表达,并分析与临床病理特征及预后的关系。表达程度与临床病理参数之间应用Spearman相关分析处理,应用Cox比例风险模型作预后因素分析。结果:ESCC组织中p16缺失率和Ki-67的阳性表达增高率分别为58.73%(37/63)和65.08%(41/63),p16缺失和Ki-67表达增高呈正相关,P=0.001。p16缺失及Ki-67阳性表达与临床分期(P值均<0.001)、淋巴转移(P值分别为0.010、0.008)呈正相关,而与肿瘤大小(P值分别为0.396和0.098)及组织学分级(P值分别为0.514和0.389)无关。Kap-lan-Meier生存分析结果显示,p16表达缺失率(P=0.004)及Ki-67的表达增高率(P=0.006)与生存时间缩短呈正相关。多因素Cox回归分析显示,p16(P=0.038)和Ki-67(P=0.044)表达、淋巴转移(P=0.021)、临床分期(P=0.031)和术后治疗(P=0.004)是影响患者预后的独立危险因素。结论:食管鳞状细胞癌组织中p16与Ki-67表达与临床分期、淋巴结转移和预后相关。p16与Ki-67检测有可能成为判断食管鳞状细胞癌分期和预后的重要分子标志,并成为重要的预后因素。
OBJECTIVE: To investigate the expression of p16 and Ki-67 in esophageal squamous cell carcinoma (ESCC) tissues, and to investigate its relationship with clinicopathological features and prognosis. Methods: The expressions of p16 and Ki-67 in 63 ESCC tissues were detected by immunohistochemical SP method. The relationship between them was analyzed with clinicopathological features and prognosis. Spearman correlation analysis was used to analyze the relationship between the expression level and clinicopathological parameters. Cox proportional hazards model was used to analyze the prognostic factors. Results: The positive rates of p16 deletion and Ki-67 expression in ESCC tissues were 58.73% (37/63) and 65.08% (41/63), respectively. There was a positive correlation between p16 deletion and Ki-67 expression (P = 0.001). There was a positive correlation between p16 deletion and Ki-67 expression and clinical stage (P <0.001), lymphatic metastasis (P = 0.010 and 0.008 respectively), but not with tumor size (P = 0.396 and 0.098, respectively) (P values of 0.514 and 0.389, respectively). Kaplan-Meier survival analysis showed that the loss of p16 (P = 0.004) and the increased rate of Ki-67 expression (P = 0.006) were positively correlated with the shortened survival time. Multivariate Cox regression analysis showed that lymph node metastasis (P = 0.021), clinical stage (P = 0.031), and postoperative treatment (P = 0.004) were related to the expression of p16 (P = 0.038) and Ki-67 Independent prognostic risk factors. Conclusion: The expressions of p16 and Ki-67 in esophageal squamous cell carcinoma are correlated with clinical stage, lymph node metastasis and prognosis. The detection of p16 and Ki-67 may be important molecular markers to determine the stage and prognosis of esophageal squamous cell carcinoma and become an important prognostic factor.