Abstract
PurposeTo investigate the distribution of Ki67+ cells in breast cancer in relation to clinical-pathological parameters and prognosis.Materials and MethodsKi67 expression status was detected in 1,086 breast cancer specimens using immunohistochemistry staining and examining the relationship between the Ki67+ cells' location. Subsequently, clinical-pathological parameters and prognosis were determined.ResultsIn total, Ki67 protein expression was found in 781 (71.92%) of the 1,086 breast cancer specimens. Among the 781 Ki67+ cases, 461 were defined as diffuse type and 320 were defined as borderline type. After universal correlation analysis, significant differences were observed in age, histological grade, metastatic nodes, postoperative distant metastasis, and molecular subtype between Ki67+ and Ki67− cases (P = 0.01, 0.001, 0.001, 0.001, and 0.001, respectively). After subgroup analysis, the borderline cases were found to be characterized by a high distant metastasis rate compared to the diffuse cases as well as the Ki67− cases (P = 0.001). No differences were observed between diffuse type or Ki67− cases (P = 0.105). Multivariate analysis showed that age, tumor size, histological grade, lymph node metastasis, molecular subtype, and the Ki67 distribution pattern were observed to be related to postoperative distant metastasis (all P<0.05). Furthermore, borderline type was shown to attain a significantly more distant bone and liver metastasis and worse disease-specific survival than the other types (P = 0.001). In the Cox regression test, the Ki67 distribution pattern was detected as an independent prognostic factor (P = 0.001).ConclusionThe distribution pattern of Ki67 may be a new independent prognostic factor for breast cancer.
Highlights
Breast cancer is one of the most common cancers and the leading cause of cancer-related death in women [1,2]
Among the 781 Ki67 positive cases, 461 cases were defined as diffuse type and 320 cases were defined as borderline type (Figure 1)
Significant differences were observed in age, histological grade, metastatic nodes, postoperative distant metastasis, and molecular subtypes
Summary
Breast cancer is one of the most common cancers and the leading cause of cancer-related death in women [1,2]. In 2008, 1,380,000 new occurrences of breast cancer were diagnosed worldwide, with 458,400 persons dying from breast cancer that same year [3,4]. Death usually results from uncontrolled metastatic disease rather than local recurrence [5]. The most common organ metastases in patients with breast cancer are bone, lung, and liver [6]. The 5-year survival rate for patients with breast cancer approaches 80%, in metastatic patients, it decreases to 20% [7]. Detecting distant metastasis early is especially important to improve the breast cancer patient’s prognosis
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