| 卢晓旭,王俊杰,孙学明,黄蓉,吴慧.Ki-67和人表皮生长因子受体-2在Ⅲ~ⅣA期唾液腺导管癌中的临床价值[J].中华放射医学与防护杂志,2022,42(10):753-758 |
| Ki-67和人表皮生长因子受体-2在Ⅲ~ⅣA期唾液腺导管癌中的临床价值 |
| Clinical value of Ki-67 and human epidermal growth factor receptor 2 in stage Ⅲ-ⅣA salivary duct carcinoma |
| 投稿时间：2022-07-15 |
| DOI：10.3760/cma.j.cn112271-20220715-00293 |
| 中文关键词: Ki-67 人表皮生长因子受体-2 唾液腺导管癌 预后 |
| 英文关键词:Ki-67 Human epidermal growth factor receptor 2 Salivary duct carcinoma Prognosis |
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| 中文摘要: |
| 目的 探讨Ki-67和人表皮生长因子受体-2(HER-2)在Ⅲ~ⅣA期唾液腺导管癌(SDC)中的临床价值。方法 回顾性分析2012年1月至2020年12月确诊的52例Ⅲ~ⅣA期SDC病例资料。全部患者均进行根治性手术及术后放疗,其中,15.4%局部区域复发,28.8%远处转移,17.3%区域复发伴远处转移。分析临床特征和Ki-67、HER-2等病理特征与局部复发、远处转移等预后的关系。χ2检验或Fisher's精确概率法检验组间比较、Kaplan-Meier法生存分析,Cox模型多因素预后分析。结果 全组中位随访时间为37.6(10.7~77.5)个月。1年和2年局部区域无复发生存(LRRFS)、无远处转移生存(DMFS)、无进展生存(PFS)率分别为 86.5%、73.1%、65.4%和67.3%、55.8%、46.2%,3年无进展生存率(PFS)为33.3%。组间比较显示,年龄≥65岁,T分期、TNM分期、脉管癌栓、放疗剂量<60 Gy、Ki-67阳性指数、HER-2阳性与不同的预后分层有关。多因素分析显示,年龄、 Ki-67阳性指数≥60%和HER-2蛋白(3+)是 Ⅲ~ⅣA 期SDC独立的预后不良因素(t =5.16、9.84、8.23, P<0.05)。结论 Ⅲ~ⅣA期SDC仅进行根治性手术及术后放射治疗的远处转移率较高,Ki-67阳性指数和HER-2阳性是其独立的预后不良因素。 |
| 英文摘要: |
| Objective To explore the clinical value of Ki-67 and human epidermal growth factor receptor 2 (HER-2) in salivary duct carcinoma in stage Ⅲ-ⅣA.Methods The data of 52 cases of locally advanced salivary duct carcinoma(SDC) diagnosed from January 2012 to December 2020 were retrospectively analyzed. All patients underwent radical surgery and postoperative radiotherapy. Among them, 15.4% of patients had local recurrence, 28.8% had distant metastasis, 17.3% had regional recurrence with distant metastasis. The relationship between clinical features, pathological features such as Ki-67 and HER-2 and prognosis such as local recurrence and distant metastasis was analyzed.Results The average follow-up time was 37.6 months. The 1- and 2-year local recurrence free survival, distant metastasis free survival, progression free survival were 86.5%, 73.1%, 65.4% and 67.3%, 55.8%, 46.2% respectively. The 3-year progression free survival rate was 33.3%. Comparison between groups showed that age ≥ 65 years old, T stage, TNM stage, vascular tumor thrombus, radiotherapy dose <60 Gy, Ki-67 positive index and HER-2 positive were related to the prognosis of different stages. In multivariate analysis, only age, Ki-67 positive index ≥ 60% and HER-2 protein (3+) were independent poor prognostic factors for locally advanced SDC (t =5.16,9.84,8.23, P<0.05).Conclusions In stage Ⅲ-ⅣA SDC, only radical surgery and postoperative radiotherapy have a high rate of distant metastasis. Ki-67 positive index and HER-2 positive are independent adverse prognostic factors. |
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