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Prognostic impact of Ki-67 in patients with gastric cancer-the importance of depth of invasion and histologic differentiation.

ABSTRACT: Ki-67 protein is a cellular marker for proliferation. The role of Ki-67 as a prognostic biomarker has not been established in gastric cancer. The present study was performed to investigate the significance of Ki-67 expression as a biomarker in early gastric cancer (EGC).With tissue microarray for 320 patients with gastric cancer, we performed immunohistochemical staining for Ki-67. Its clinical significance was analyzed with adjustment via the propensity score-matching. For validation, we performed bootstrap resampling.The median follow-up duration was 72 months (range: 3-120 months). Ki-67-high group showed worse prognosis than Ki-67-low group in EGC (5-YSR, 78.9% vs 92.0%, P? = ?.018), but not in advanced gastric cancer (AGC) (5-YSR, 58.5% vs 59.2%, P? = ?.951). Interestingly, in the patients with well-differentiated histology, prognosis for Ki-67-high group was considerably worse than that for Ki-67-low group (5-YSR, 67.0% vs 94.4%, P? = ?.012), but not in those with moderately differentiated (P? = ?.504) and poorly differentiated histology (P? = ?.905). In this cohort, there was a strong correlation between the proportion of EGC and well-differentiated histology (r? = ?0.215, P? = ?.002). Multivariate analysis also revealed that the high-Ki-67 expression serves as a poor prognostic factor in EGC (HR 4.346, 95% CI 1.397-13.515, P? = ?.011), especially in the well-differentiated histology, but not in all the patients (P? = ?.171). Bootstrap resampling internally validated this result (P? = ?.011).This study suggests that Ki-67 expression may be a good biomarker for prognosis prediction for EGC with well-differentiated histologic type.

SUBMITTER: Ko GH

PROVIDER: S-EPMC5484207 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Prognostic impact of Ki-67 in patients with gastric cancer-the importance of depth of invasion and histologic differentiation.

Ko Gyung Hyuck GH Go Se-Il SI Lee Won Sup WS Lee Jeong-Hee JH Jeong Sang-Ho SH Lee Young-Joon YJ Hong Soon Chan SC Ha Woo Song WS

Medicine 20170601 25

Ki-67 protein is a cellular marker for proliferation. The role of Ki-67 as a prognostic biomarker has not been established in gastric cancer. The present study was performed to investigate the significance of Ki-67 expression as a biomarker in early gastric cancer (EGC).With tissue microarray for 320 patients with gastric cancer, we performed immunohistochemical staining for Ki-67. Its clinical significance was analyzed with adjustment via the propensity score-matching. For validation, we perfor ...[more]

PMID: 28640099

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Project description:Several studies have shown that estrogen receptor (ER) and progesterone receptor (PR) expression and human epidermal growth factor receptor 2 (HER2) expression may vary during tumoral progression. We aimed to describe and compare ER, PR, and HER2 expressions in primary breast tumors and synchronic axillary nodal metastases, and evaluate phenotypic correlations between them.Patients were identified prospectively through surgical procedures between September 2013 and July 2016. The status of ER, PR, HER2, and Ki-67 were pathologically analyzed in breast cancers and axillary nodal metastases; these patients were classified based on the breast cancer phenotypes into five subgroups.Synchronic axillary nodal metastases were observed in 127 patients. In breast cancers and nodal metastases, correlation analyses of ER, PR, and Ki-67 expression showed a statistical dependence and concordance between these samples was unambiguously demonstrated through Bland-Altman plots for each determination. Primary breast tumors were classified as follows: luminal A, 41.6%; luminal B, 40.0%; luminal B/HER2, 9.6%; HER2, 2.4%; triple negative, 6.4%. Alterations in phenotype were observed in 28% of patients. The most frequent phenotypic alteration was from luminal B to A (36.4%). Ten cases (30.3%) showed alterations with therapeutic implications; six gained HER2 overexpression, and four, hormonal receptor (HR) expression. A moderate strength of agreement (Cohen's κ coefficient, 0.59; 95% confidence interval, 0.48-0.71) was observed. In multivariate analyses, high histologic grade (odds ratio [OR], 2.79; p<0.047) and high Ki-67 expression (OR, 1.05; p<0.037) were independent factors predictive of phenotypic alterations.Strong correlations were observed in HR and Ki-67 expressions between primary breast tumors and axillary nodal metastases, and a moderate concordance was observed in their phenotypical characteristics. Nevertheless, alterations did exist, and one-third of these changes may have therapeutic implications. The nodal metastases of tumors with high grade and high Ki-67 expression may need to be analyzed, to obtain complete therapeutic information.

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Prognostic impact of Ki-67 in patients with gastric cancer-the importance of depth of invasion and histologic differentiation.

Publications

Prognostic impact of Ki-67 in patients with gastric cancer-the importance of depth of invasion and histologic differentiation.

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