CAJ | 학술논문

目的：探讨Gli-2蛋白和核增殖标志物Ki-67与胸腺肿瘤的临床病理特征及预后的关系。方法：采用免疫组织化学方法，检测64例胸腺肿瘤（9例A型、6例AB型、11例B1型、22例B2型及16例C型）组织中Gli-2及Ki-67蛋白的表达情况。结果：1） Gli-2在胸腺瘤A、AB、B1、B2、C型的阳性率分别为1/9（11.11%）、2/6（33.33%）、2/11（18.18%）、5/22（22.73%）、13/16（81.25%），表达差异有统计学意义（P<0.05）；Gli-2阳性率在Masaoka分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期中分别为2/10（20%）、12/41（29.27%）、4/6（66.67%）、5/7（71.43%），表达差异有统计学意义（P<0.05）；2）患者肿瘤组织中Gli-2的高表达与性别、年龄、出血坏死及合并重症肌无力（my?asthenia gravis, MG）无相关性，但与肿瘤是否侵及胸膜密切相关；3）Ki-67在侵袭性胸腺瘤与非侵袭性胸腺瘤中的阳性标记指数（LI）分别为7.14±6.99、15.24±9.13，差异具有明显统计学意义（P<0.05），Ki-67在胸腺瘤中的表达与Gli-2的表达呈正相关（rs=0.529，P<0.05）；4）Gli-2阳性组患者5年无进展生存率（PFS）56.5%（13/23）较阴性组的5年无进展生存率92.7%（38/41）低，Ki-67阳性组的胸腺肿瘤患者5年无进展生存率61.5%（16/26）也较阴性组的5年无进展生存率92.1%（35/38）低，且差异具有统计学意义（P<0.05）。Cox比例风险回归模型分析结果显示，Gli-2阳性、Ki-67阳性、有胸膜侵袭是影响胸腺肿瘤患者预后的独立危险因素。结论：Gli-2与Ki-67在胸腺肿瘤组织中的表达呈正相关，检测二者的表达对判断胸腺肿瘤患者的临床特征及预后有一定提示作用。
목적：탐토Gli-2단백화핵증식표지물Ki-67여흉선종류적림상병리특정급예후적관계。방법：채용면역조직화학방법，검측64례흉선종류（9례A형、6례AB형、11례B1형、22례B2형급16례C형）조직중Gli-2급Ki-67단백적표체정황。결과：1） Gli-2재흉선류A、AB、B1、B2、C형적양성솔분별위1/9（11.11%）、2/6（33.33%）、2/11（18.18%）、5/22（22.73%）、13/16（81.25%），표체차이유통계학의의（P<0.05）；Gli-2양성솔재Masaoka분기Ⅰ、Ⅱ、Ⅲ、Ⅳ기중분별위2/10（20%）、12/41（29.27%）、4/6（66.67%）、5/7（71.43%），표체차이유통계학의의（P<0.05）；2）환자종류조직중Gli-2적고표체여성별、년령、출혈배사급합병중증기무력（my?asthenia gravis, MG）무상관성，단여종류시부침급흉막밀절상관；3）Ki-67재침습성흉선류여비침습성흉선류중적양성표기지수（LI）분별위7.14±6.99、15.24±9.13，차이구유명현통계학의의（P<0.05），Ki-67재흉선류중적표체여Gli-2적표체정정상관（rs=0.529，P<0.05）；4）Gli-2양성조환자5년무진전생존솔（PFS）56.5%（13/23）교음성조적5년무진전생존솔92.7%（38/41）저，Ki-67양성조적흉선종류환자5년무진전생존솔61.5%（16/26）야교음성조적5년무진전생존솔92.1%（35/38）저，차차이구유통계학의의（P<0.05）。Cox비례풍험회귀모형분석결과현시，Gli-2양성、Ki-67양성、유흉막침습시영향흉선종류환자예후적독립위험인소。결론：Gli-2여Ki-67재흉선종류조직중적표체정정상관，검측이자적표체대판단흉선종류환자적림상특정급예후유일정제시작용。
Objective:To investigate the expression of Gli-2 protein and nuclear proliferation marker Ki-67 in human thymic tu-mors, as well as its relationship with clinicopathological features and prognosis. Methods: Immunohistochemical staining was per-formed to determine the expressions of Gli-2 and Ki-67 in 64 thymic tumor cases, in which 9 were type A, 6 were type AB, 11 were type B1, 22 were type B2, and 16 were type C. Results:1) Positive expression rates of Gli-2 in types A, AB, B1, B2, and C thymomas were 1/9 (11.11%), 2/6 (33.33%), 2/11 (18.18%), 5/22 (22.73%), and 13/16 (81.25%), respectively. Statistically significant differences existed in the two sets of data (P<0.05). Positive rates of Gli-2 in the Masaoka stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 2/10 (20%), 12/41 (29.27%), 4/6 (66.67%), and 5/7 (71.43%), respectively. The statistical differences of these two sets of data were also significant (P<0.05). 2) The expression levels of Gli-2 in tumor tissues were closely correlated with the pleura (P<0.05) but not associated with gen-der, age, myasthenia gravis, and necrosis with hemorrhage (P>0.05). 3) The positive labeling indexes of Ki-67 in invasive and non-inva-sive thymomas were 7.14 ± 6.99 and 15.24 ± 9.13, respectively. The differences between both thymomas were statistically significant (P<0.05). 4) A positive correlation existed in the expression of Ki-67 and Gli-2 in thymomas. Five-year progression-free survival (PFS) rate was lower in the Gli-2 positive group (56.5%, 13/23) than in the negative group (92.7%, 38/41). The Ki-67-positive group (61.5%, 16/26) also showed a lower five-year PFS than that in the negative group (92.1%, 35/38), with statistically significant differences be-tween the two groups (P<0.05). Multivariate Cox's proportional hazard regression analysis indicated that the Gli-2-positive group ex-pression, Ki-67-positive group expression, and invasion of the pleura were independent prognostic factors of thymic tumors. Conclu-sion:The expression of Gli-2 and Ki-67 showed a positive correlation with thymic tumors. Detecting the combined expression of Gli-2 and Ki-67 may elucidate the clinicopathological features and prognoses of patients with thymic tumors.