1
|
Jia M, Pi J, Zou J, Feng M, Chen H, Lin C, Yang S, Xiao X. The Potential Value of Ki-67 in Prognostic Classification in Early Low-Risk Endometrial Cancer. Cancer Control 2023; 30:10732748231206929. [PMID: 37924202 PMCID: PMC10625729 DOI: 10.1177/10732748231206929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 11/06/2023] Open
Abstract
PURPOSE This study aims to determine the optimal cut-off value of Ki-67 to better predict the recurrence of early low-risk endometrial cancer (EC). METHODS Seven hundred and forty-eight patients diagnosed with low-risk EC from West China Second Hospital of Sichuan University and the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The receiver operating characteristic curve (ROC) and Youden index were used to calculate the optimal cut-off value of Ki-67 expression. The clinicopathological indexes between two groups divided by cut-off value of Ki-67 were compared. The univariate and multivariate regression analyses were performed to investigate risk factors connected to the recurrence of early low-risk EC. The survival analysis was shown in Kaplan-Meier curve. RESULT Thirty-three patients were detected with tumor recurrence after primary surgery (4.4%); 33% was the optimal cut-off value of the Ki-67 index. A high Ki-67 was significantly associated with age (P = .002), myometrial invasion (P < .001), and the expression of P53 (P = .007). The multivariate regression analysis verified that Ki67 ≥ 33% was an independent prognostic factor for predicting recurrence. The recurrence-free survival (RFS) and the overall survival (OS) in high Ki-67 group was significantly lower than that in low Ki-67 group (P < .001 and P = .029, respectively). The prognostic values of ER, PR, and P53 in combination with Ki-67 were superior to each single predictor. CONCLUSIONS The optimal cut-off value of Ki-67 for predicting recurrence is 33%, which quantitatively defines the specific value of Ki-67 that causes high-risk recurrence in early low-risk EC.
Collapse
Affiliation(s)
- Mingzhu Jia
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jiangchuan Pi
- Department of urology, Chengdu Second People’s Hospital, Chengdu, China
| | - Juan Zou
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Min Feng
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Huiling Chen
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Changsheng Lin
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shuqi Yang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xue Xiao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Zhao X, Yang X, Fu L, Yu K. Associations of Estrogen Receptor, Progesterone Receptor, Human Epidemic Growth Factor Receptor-2 and Ki-67 with Ultrasound Signs and Prognosis of Breast Cancer Patients. Cancer Manag Res 2021; 13:4579-4586. [PMID: 34135634 PMCID: PMC8200160 DOI: 10.2147/cmar.s276422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/10/2021] [Indexed: 01/05/2023] Open
Abstract
Objective The functions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 in breast cancer have been explored. This study was carried out to explore ER, PR, HER-2 and Ki-67 expression levels in breast cancer patients and their relationship with ultrasound signs and prognosis. Patients and Methods A total of 274 female primary breast cancer patients received preoperative ultrasound examination. ER, PR, HER-2 and Ki-67 expression levels in breast cancer tissues were detected by immunohistochemical staining after surgery. The correlations of ER, PR, HER-2 and Ki-67 expression with ultrasound signs and prognosis of breast cancer patients were analyzed. Results The positive expression rate of ER, PR and HER-2 and Ki-67 high expression in 274 breast cancer patients was 73.36% (201/274), 59.85% (164/274), 24.09% (66/274) and 66.06% (181/274), respectively. ER-positive expression had association with lymph node metastasis (LNM) and blood flow grading; HER-2-positive expression was associated with LNM, while Ki-67-positive expression was related to the tumor diameter, LNM, and blood flow grading. LNM and Ki-67 high expression were risk factors for OS; PR-positive was a protective factor for OS; TNM stage, tumor diameter, LNM and Ki-67 high expression were risk factors for DFS in breast cancer patients. Conclusion ER, PR, HER-2 and Ki-67 in breast cancer are related to the ultrasound signs and prognosis of breast cancer patients. The joint detection of multiple indicators provides a reference for the individualized treatment of targeted drugs.
Collapse
Affiliation(s)
- Xingjuan Zhao
- Department of Mammary Gland, Shanxi People's Hospital, Taiyuan City, Shanxi Province, 030000, People's Republic of China
| | - Xuan Yang
- Department of Mammary Gland, Shanxi People's Hospital, Taiyuan City, Shanxi Province, 030000, People's Republic of China
| | - Lei Fu
- Department of Surgery, Shanxi Provincial General Team Hospital of the Chinese People's Armed Police Force, Taiyuan City, Shanxi Province, 030000, People's Republic of China
| | - Keda Yu
- Department of Mammary Gland, Fudan University Cancer Hospital, Taiyuan City, Shanxi Province, 030000, People's Republic of China
| |
Collapse
|
3
|
Kamranzadeh H, Ardekani RM, Kasaeian A, Sadighi S, Maghsudi S, Jahanzad I, Maleki N. Association between Ki-67 expression and clinicopathological features in prognosis of breast cancer: A retrospective cohort study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2019; 24:30. [PMID: 31143231 PMCID: PMC6521610 DOI: 10.4103/jrms.jrms_553_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/13/2018] [Accepted: 01/30/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Breast cancer is the most common diagnosed female cancer. Breast cancer is also the leading cause of cancer death in females accounting for 13.7% of female cancer-related mortality globally. Variable known prognostic factors such as histological tumor type, tumor size, nodal status, grade, age, and estrogen receptor (ER) status and the proliferation marker - Ki-67 influence the type of treatment decision. The purpose of this present study is to investigate the association between Ki-67 expression with several clinicopathological variables and patients' outcome. MATERIALS AND METHODS This is a retrospective cohort study from September 2008 to March 2017; 165 newly diagnosed breast cancer patients were enrolled in the study. Ki67 levels were measured using immunohistochemistry and compared with clinicopathological variables. The relation of Ki67 expression with disease-free survival (DFS) and overall survival (OS) was also analyzed. RESULTS The result of this study revealed that age, tumor size, menopausal status, and human epidermal growth factor receptor 2 (HER2) status had no effect on the patients' outcome. Patients with ER-positive, progesterone receptor (PR)-positive, and HER2-negative tumors expressed a higher rate of Ki-67 (>10%) than patients with ER-negative, PR-negative, and HER2-positive tumors, respectively. However, we found that Ki-67 levels were not significantly increased statistically with ER, PR, and HER2 statuses. There was a statistically significant correlation between Ki-67 expression and with higher stages of the disease. Multivariate analysis showed that Ki-67 expression could not to be an independent prognostic factor for 5-year OS and DFS. Furthermore, p53 status was only prognostic factor for 5-year OS whereas higher stages of disease and p53 status were prognostic factors for 5-year DFS. CONCLUSION Ki67 could not be an independent variable for prediction of breast cancer outcome.
Collapse
Affiliation(s)
- Hosein Kamranzadeh
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Manouchehri Ardekani
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanambar Sadighi
- Department of Medical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Maghsudi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Issa Jahanzad
- Department of Pathology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrollah Maleki
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Song B, Wang L, Zhang Y, Li N, Dai H, Xu H, Cai H, Yan J. Combined Detection of HER2, Ki67, and GSTP1 Genes on the Diagnosis and Prognosis of Breast Cancer. Cancer Biother Radiopharm 2018; 34:85-90. [PMID: 30585764 DOI: 10.1089/cbr.2018.2570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Breast cancer (BC) is a common malignant tumor in females. The combined assay of multiple molecular markers benefits the diagnosis and prognostic prediction. Human epidermal growth factor receptor 2 (HER2) facilitates the proliferation and differentiation of cancer cells through ligand binding. Ki67 is a tumor proliferation-related gene, whereas GSTP1 is a DNA repair-related gene. This study thus investigated the significance of HER2 and Ki67/GSTP1 gene combined assay in the diagnosis and prognosis of BC. MATERIALS AND METHODS A total of 86 breast tumor tissues and adjacent tissues were collected. Gene expression and protein levels of HER2 and Ki67 were quantified by real-time polymerase chain reaction (PCR) and Western blot, respectively. Methylation frequency of GSTP1 was analyzed by methylation-specific PCR. The correlation between HER2 and Ki67/GSTP1 and clinical/pathological features of BC was analyzed. RESULTS Gene and protein expression levels of HER2 and Ki67 in tumor tissues were increased (p < 0.05 compared with adjacent tissues). Methylation frequency of GSTP1 gene was 37.2%, which was significantly higher in breast tumor tissues than in adjacent tissues (12.79%, p < 0.05). HER2 expression was positively correlated with TNM stage, tumor size, and lymph node metastasis, and negatively correlated with tissue grade and estrogen receptor (ER)/progesterone receptor (PR) expression (p < 0.05). GSTP1 methylation was positively correlated with TNM stage and tumor size, and negatively correlated with ER/PR expression (p < 0.05). CONCLUSIONS HER2, Ki67, and GSTP1 methylation were correlated with clinical and pathological features of BC. The combined assay benefits the early diagnosis and prognostic prediction of cancer.
Collapse
Affiliation(s)
- Bo Song
- 1 Breast Surgery Department, Shandong Tengzhou Maternity and Children Care Hospital, Tengzhou, China
| | - Lu Wang
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Yang Zhang
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Ning Li
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Hao Dai
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Huafang Xu
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Haifeng Cai
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| | - Jinyin Yan
- 2 Department of Surgical Oncology, Tangshan People's Hospital, Tangshan, Hebei, China
| |
Collapse
|
5
|
Chen M, Yao S, Cao Q, Xia M, Liu J, He M. The prognostic value of Ki67 in ovarian high-grade serous carcinoma: an 11-year cohort study of Chinese patients. Oncotarget 2017; 8:107877-107885. [PMID: 29296209 PMCID: PMC5746111 DOI: 10.18632/oncotarget.14112] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/19/2016] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study sought to assess the prognostic role of Ki67 in primary ovarian high-grade serous carcinoma (HGSC) and to determine whether Ki67 expression can predict responsiveness to platinum and paclitaxel chemotherapy. RESULTS A total of 318 women were included in the analysis and the median follow-up time was 48 months (range, 3-150 months). Ki67 proliferation indices ranged from 3% to 95% with a median of 40%. Using 40% as the cut-off value for the Ki67 index, we classified 141 patients as having low Ki67 expression and 177 patients as having high Ki67 expression. Low Ki67 expression was a predictor of platinum resistance (hazard ratio (HR) 2.85, 95% CI 1.43-5.98, P < 0.001). In the Kaplan-Meier analysis, comparisons of patients with low versus high Ki67 expression demonstrated that low Ki67 expression was significantly associated with decreased progression-free survival (PFS) (22% vs. 34% for 5-year PFS, P < 0.001) and decreased overall survival (OS) (31% vs. 55%, P < 0.001). Multivariate analysis indicated that low Ki67 expression was associated with decreased PFS (HR 2.98, 95% CI 1.75-6.56, P < 0.001) and decreased OS (HR 1.74, 95% CI 1.38-5.01, P = 0.003). MATERIALS AND METHODS A retrospective study of patients with stage I-IV primary ovarian HGSC was conducted from January 1, 2002, to December 31, 2012. Ki67 levels were measured via immunohistochemistry (IHC) and analyzed with respect to clinicopathological factors, and a survival analysis was performed. CONCLUSIONS HGSC appears to be a heterogeneous disease with different clinical outcomes. Low Ki67 expression (< 40%) in HGSC is significantly associated with platinum resistance and decreased survival.
Collapse
Affiliation(s)
- Ming Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shuzhong Yao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qinghua Cao
- Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Meng Xia
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Junxiu Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Mian He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|