Correlation of the prognostic impact of Ki67/BCL2 index based on immunohistochemistry with poor clinical outcome in gastric cancer.

Abstract

61 Background: Considering the heterogeneity of gastric cancer, it is particularly important to identify potential prognostic indicators. Ki67 and B-cell lymphoma 2 (BCL2) proteins are known prognostic markers in different types of cancer. Ki67 is associated with cell proliferation, whereas BCL2 has anti-proliferative roles. A combined marker based on these opposite functions might provide improved prognostic information in gastric cancer. The aim of this study is to investigate correlations between a combined marker using Ki67 and BCL2 and clinicopathologic parameters, and to evaluate the prognostic value of the combinatorial marker in patients with different types of gastric cancer. Methods: This study assessed Ki67 and BCL2 expression using tissue microarray obtained from 276 patients with adenocarcinoma of the stomach. A Ki67/BCL2 index based on the relative expression of each protein was divided into low- and high-risk groups using receiver operating characteristic (ROC) curves. Results: High Ki67/BCL2 index was significantly associated with advanced AJCC stage, high recurrence, diffuse or mixed type, high histological grade, and the presence of lymphatic and perineural invasion (all p < 0.05). Univariate and multivariate analyses revealed a significant relationship between disease-free or overall survival and Ki67/BCL2 index in intestinal-type gastric cancer(all p < 0.05). Conclusions: A combined marker using Ki67 and BCL2 could be a useful indicator for predicting survival in patients with intestinal-type gastric cancer.