Abstract
BackgroundThis study evaluated the distribution pattern of the Ki67-labeling index (LI) among patients at a Chinese breast cancer center, and analyzed its prognostic significance in the 2015 St Gallen consensus breast cancer classification, estrogen receptor-positive and human epidermal growth factor receptor 2-negative(ER+/HER2−)subtype.MethodsWe classified 939 women with ER+/HER2− breast cancer into three groups by Ki67-LI levels, and followed their clinicopathologic characteristics and prognoses.ResultsIn the 939 eligible subjects, 342 had Ki67-LI ≤10% (Ki67Low), 281 had Ki67-LI between 10 and 30% (Ki67Medium), and 316 had Ki67-LI ≥30% (Ki67High). Although the Ki67High group had less favorable clinicopathologic factors, the Ki67Medium group’s factors varied considerably. Kaplan-Meier estimates showed that disease-free survival(DFS) for the Ki67Medium group was significantly shorter than the Ki67Low group but longer than the Ki67High group. Ki67-LI had independent prognostic significance in multivariate analysis. Other diagnostic factors, including tumor size >2 cm, positive lymph nodes, and grade III disease, were significantly associated with poorer disease-free survival only in the Ki67Medium group.ConclusionsFor patients with ER+/HER2− breast cancer, we confirmed three distinct risk patterns by Ki67-LI levels according to the 2015 St Gallen consensus. For patients with clearly low or high Ki67-LI, straightforward clinical decisions could be offered, but for patients with intermediate Ki67-LI, other factors might provide valuable information.
Highlights
This study evaluated the distribution pattern of the Ki67-labeling index (LI) among patients at a Chinese breast cancer center, and analyzed its prognostic significance in the 2015 St Gallen consensus breast cancer classification, estrogen receptor-positive and human epidermal growth factor receptor 2-negative(ER+/HER2−)subtype
At the latest 2015 St Gallen International Breast Cancer Conference, the panel recommended Ki67-LI should be interpreted upon local laboratory values, and ER+/HER2− Breast cancer (BC) could not be classified as
This study evaluated Ki67-LI distribution in a Chinese BC treatment center and analyzed its prognostic significance in the 2015 St Gallen consensus of ER+/HER2− BCs
Summary
This study evaluated the distribution pattern of the Ki67-labeling index (LI) among patients at a Chinese breast cancer center, and analyzed its prognostic significance in the 2015 St Gallen consensus breast cancer classification, estrogen receptor-positive and human epidermal growth factor receptor 2-negative(ER+/HER2−)subtype. Among estrogen receptor-positive and human epidermal growth factor receptor 2-negative (ER+/HER2−) BCs, gene expressionbased assays showed that they can be divided into at least two distinct subgroups—luminal A and luminal B [4]. The 2011 St Gallen consensus panel [7] recommended a cut-off of 14% for the Ki67-labeling index (LI) as the threshold between luminal A and B subtypes. At the latest 2015 St Gallen International Breast Cancer Conference, the panel recommended Ki67-LI should be interpreted upon local laboratory values, and ER+/HER2− BCs could not be classified as.
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