MP13-07 PRACTICAL APPLICATION OF KI67 IN RECURRENCE PREDICTION IN LOCALIZED MUSCLE-INVASIVE UROTHELIAL CARCINOMA: A PROSPECTIVE STUDY FROM BENCH TO BEDSIDE

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I (MP13)1 Sep 2021MP13-07 PRACTICAL APPLICATION OF KI67 IN RECURRENCE PREDICTION IN LOCALIZED MUSCLE-INVASIVE UROTHELIAL CARCINOMA: A PROSPECTIVE STUDY FROM BENCH TO BEDSIDE Che Hsueh Yang, Wei Chun Weng, Yen Chuan Ou, Yi Sheng Lin, Li Hua Huang, Chin Heng Lu, Tang Yi Tsao, Chao Yu Hsu, and Min Che Tung Che Hsueh YangChe Hsueh Yang More articles by this author , Wei Chun WengWei Chun Weng More articles by this author , Yen Chuan OuYen Chuan Ou More articles by this author , Yi Sheng LinYi Sheng Lin More articles by this author , Li Hua HuangLi Hua Huang More articles by this author , Chin Heng LuChin Heng Lu More articles by this author , Tang Yi TsaoTang Yi Tsao More articles by this author , Chao Yu HsuChao Yu Hsu More articles by this author , and Min Che TungMin Che Tung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001994.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ki67 is enhanced in interphase and mitotic phase in cell cycle, and is especially important in forming perichromosomal layer from prophase to telophase during mitosis. Its overexpression can be observed in abnormally proliferative cells such as cancer cells. There are still no documented immunohistochemical (IHC) markers in National Comprehensive Cancer Network guideline to predict the recurrence of muscle-invasive urothelial carcinoma (MIUC). Moreover, there are no prospectively designed studies regarding predictive roles of Ki67 in MIUC. In this study, we validated the prognostic value of Ki67 with a prospectively designed protocol. METHODS: We adopted specimens of localized MIUC from either the upper or lower urinary tract from 2016 to 2018 to perform the nuclear stain, Ki67 (MIB-1 clone; Dako). Their prognostic value on predicting recurrent episodes was then assessed. All specimens were extirpated from either radical cystectomy or nephroureterectomy with bladder cuff excision, and the unified protocols were applied to process them. Positivity was estimated with direct counting of hot spots from whole section, and 40% was defined to be diffuse expression. Univariable and multivariable logistic regression, and Kaplan-Meier curve were carried out by SPSS 26. Acceptable rate of type 1 error was 5%. The odds ratio (OR) was expressed with a 95% confidence interval (CI). RESULTS: A total of 50 patients were followed for 25.10 (standard deviation (SD): 8.31) months. There were 24 patients (48%) experiencing recurrence, while the other 26 (52%) did not. Twenty-four patients were diagnosed with localized MIUC of the upper urinary tract, and the other 26 were of the lower urinary tract. Females were more vulnerable to recurrence than the males (OR: 30.89 (4.40 – 216.83); multivariable logistic p= 0.001). Ki67 levels were 54.17% (SD: 19.32) and 30.54% (SD: 26.84) in with recurrence and without recurrence, respectively (OR: 1.04 (1.01—1.07); univariable logistic p= 0.003). Diffuse expression of Ki67 was an independent factor to recurrence (OR: 8.56 (1.95 -37.55); multivariable logistic p = 0.004), and recurrence-free survival interval (median recurrence-free survival: 18.50 months; 95%CI: 16.03—20.97 months; Log-rank test p=0.004). CONCLUSIONS: Diffuse Ki67 expression is a robust indicator predicting the recurrence of localized urinary tract MIUC after definite treatment with proper processing principles and interpretative protocols. Source of Funding: I have nothing to disclose © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e245-e245 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Che Hsueh Yang More articles by this author Wei Chun Weng More articles by this author Yen Chuan Ou More articles by this author Yi Sheng Lin More articles by this author Li Hua Huang More articles by this author Chin Heng Lu More articles by this author Tang Yi Tsao More articles by this author Chao Yu Hsu More articles by this author Min Che Tung More articles by this author Expand All Advertisement Loading ...