CAJ | 학술논문

目的：探讨胶质瘤患者瘤周水肿（ PTBE）程度、肿瘤病理级别、Ki-67阳性表达率三者之间的相关性。方法收集新疆自治区人民医院神经外科2010—2013年经手术切除，病理证实的胶质瘤患者病历资料及标本74例，根据术前磁共振成像（ MRI ）资料判断肿瘤 PTBE程度，免疫组织化学检测Ki-67表达情况，HE染色区别肿瘤病理级别。结果本组研究中90.54%（67/74）伴发PTBE，其中Ⅰ、Ⅱ、Ⅲ、Ⅳ级别组PTBE发生率各为100%（3/3）、78.95%（15/19）、83.33%（15/18）及100%（34/34）；75.68%（56/74）Ki-67表达呈阳性；Ⅰ、Ⅱ、Ⅲ、Ⅳ级别组阳性率分别为0、36.84%（7/19）、94.44%（17/18）、94.12%（32/34）；无水肿、Ⅰ度水肿与Ⅱ水肿组中Ki-67表达阳性率分别为57.14%（4/7）、60.00%（6/10）、80.70%（46/57）。经Kruskal-Wallis H检验，PTBE在不同级别胶质瘤的总体差异有统计学意义（H＝11.304，P＝0.010）；Ki-67在不同级别胶质瘤中总体差异有统计学意义（H＝38.530，P﹤0.05）；Ki-67在不同PTBE组中表达的总体差异有统计学意义（ H＝6.478，P＝0.039）。Spearman等级相关分析显示胶质瘤PTBE程度随肿瘤病理级别增加而增加（ r＝0.385，P＝0.001）；Ki-67表达阳性率随肿瘤病理级别增加而增加（ r ＝0.692，P ﹤0.05）；Ki-67表达阳性率随胶质瘤 PTBE 增加而增加（ r ＝0.256，P＝0.028）。结论术前根据PTBE的大小可预测肿瘤的恶性程度与增殖活性，Ki-67既可作为肿瘤增殖活性的指标，也可当做病理分级的重要依据。
목적：탐토효질류환자류주수종（ PTBE）정도、종류병리급별、Ki-67양성표체솔삼자지간적상관성。방법수집신강자치구인민의원신경외과2010—2013년경수술절제，병리증실적효질류환자병력자료급표본74례，근거술전자공진성상（ MRI ）자료판단종류 PTBE정도，면역조직화학검측Ki-67표체정황，HE염색구별종류병리급별。결과본조연구중90.54%（67/74）반발PTBE，기중Ⅰ、Ⅱ、Ⅲ、Ⅳ급별조PTBE발생솔각위100%（3/3）、78.95%（15/19）、83.33%（15/18）급100%（34/34）；75.68%（56/74）Ki-67표체정양성；Ⅰ、Ⅱ、Ⅲ、Ⅳ급별조양성솔분별위0、36.84%（7/19）、94.44%（17/18）、94.12%（32/34）；무수종、Ⅰ도수종여Ⅱ수종조중Ki-67표체양성솔분별위57.14%（4/7）、60.00%（6/10）、80.70%（46/57）。경Kruskal-Wallis H검험，PTBE재불동급별효질류적총체차이유통계학의의（H＝11.304，P＝0.010）；Ki-67재불동급별효질류중총체차이유통계학의의（H＝38.530，P﹤0.05）；Ki-67재불동PTBE조중표체적총체차이유통계학의의（ H＝6.478，P＝0.039）。Spearman등급상관분석현시효질류PTBE정도수종류병리급별증가이증가（ r＝0.385，P＝0.001）；Ki-67표체양성솔수종류병리급별증가이증가（ r ＝0.692，P ﹤0.05）；Ki-67표체양성솔수효질류 PTBE 증가이증가（ r ＝0.256，P＝0.028）。결론술전근거PTBE적대소가예측종류적악성정도여증식활성，Ki-67기가작위종류증식활성적지표，야가당주병리분급적중요의거。
Objective To explore the correlation of peritumoral brain edema( PTBE)size,histologi-cal grades and the expression rate of Ki-67 in gliomas. Methods The data and specimens about 74 cases of gliomas in People's Hospital of Xinjiang Uygur Autonomous Region during 2010-2013 were collected. All cases were confirmed by surgery and pathology. According to preoperative MRI,PTBE was graded. Immunohisto-chemical discriminate the expression of Ki-67. HE coloration distinguish the histological grades. Results In this study,90. 54%(67/74)patients occured PTBE,the incidence of PTBE inⅠ,Ⅱ,Ⅲ,Ⅳlevel of groups were 100%(3/3),78. 95%(15/19),83. 33%(15/18),100%(34/34). Ki-67 expression was positive in 75. 68%(56/74)patients,and the rates were 0,36. 84%(7/19),94. 44%(17/18),94. 12%(32/34) in Ⅰ,Ⅱ,Ⅲ,Ⅳ level of groups. The expression rate of Ki-67 was 57. 14%(4/7),60. 00%(6/10),and 80. 70%(46/57)in normal group,Ⅰ-level groups of PTBE,Ⅱ-level groups of PTBE. The result of Kruskal-Wallis H showed that the PTBE from different grades was statistically significant(H=11. 304,P=0. 010). The expression rate of Ki-67 in different grade gliomas was statistically significant(H=38. 530,P﹤0. 05), The difference of expression Ki-67 in gliomas of different PTBE was statistically significant( H=6. 478,P=0. 039). The result of Spearman rank correlation analysis showed that the PTBE level increased with the histo-logical grade up in gliomas(r=0. 385,P=0. 001). The expression rate of Ki-67 increased with the histologi-cal grade up in gliomas(r=0. 692,P﹤0. 05),and the expression rate of Ki-67 increased with the degree of PTBE up in glomas( r =0. 256,P =0. 028 ). Conclusion Accorrding to the PTBE size,the histological grades and proliferation ability of glioma can be judged pre-operation. Ki-67 can be used as the indicator of pro-liferation activity of tumor,and also be used as the important basis of histological grades.