Value Of Ki-67 In Patients Research Articles

Prognostic heterogeneity of Ki67 in non-small cell lung cancer: A comprehensive reappraisal on immunohistochemistry and transcriptional data.

In the present study, the debatable prognostic value of Ki67 in patients with non-small cell lung cancer (NSCLC) was attributed to the heterogeneity between lung adenocarcinoma (LUAD) and lung squamous carcinoma (LUSC). Based on meta-analyses of 29 studies, a retrospective immunohistochemical cohort of 1479 patients from our center, eight transcriptional datasets and a single-cell datasets with 40 patients, we found that high Ki67 expression suggests a poor outcome in LUAD, but conversely, low Ki67 expression indicates worse prognosis in LUSC. Furthermore, low proliferation in LUSC is associated with higher metastatic capacity, which is related to the stronger epithelial-mesenchymal transition potential, immunosuppressive microenvironment and angiogenesis. Finally, nomogram model incorporating clinical risk factors and Ki67 expression outperformed the basic clinical model for the accurate prognostic prediction of LUSC. With the largest prognostic assessment of Ki67 from protein to mRNA level, our study highlights that Ki67 also has an important prognostic value in NSCLC, but separate evaluation of LUAD and LUSC is necessary to provide more valuable information for clinical decision-making in NSCLC.

Prognostic and clinicopathological value of Ki-67 in patients with oesophageal squamous cell carcinoma: a systematic review and meta-analysis

ObjectivesThe relationship between Ki-67 expression and the prognosis of patients with oesophageal squamous cell carcinoma (ESCC) has been extensively studied. However, their findings were inconsistent. Consequently, the present meta-analysis was...

Prognostic value of Ki-67 in patients with ovarian cancer

This study aimed to investigate the prognostic value of Ki-67 antigen (Ki-67) in patients with epithelial ovarian cancer. A retrospective review identified a cohort of 78 patients with epithelial ovarian cancer. The association between Ki-67 expression and clinicopathological characteristics and survival was analyzed. High Ki-67 expression was significantly associated with high stage, high histological grade, ascites, and high level of cancer antigen 125 (CA125) (p = 0.011, p = 0.031, p = 0.033, p = 0.004, respectively). In addition, high Ki-67 expression was significantly associated with poor prognosis (p = 0.002), which was further confirmed using a multivariate Cox regression hazards model (Hazard Ratio (HR) = 1.797, 95% confidence interval (CI) = 1.038–3.111, p = 0.026). In conclusion, Ki-67 expression may be a significant prognostic factor in epithelial ovarian cancer.

Prognostic Value of Ki67 in Patients with Stage 1-2 Endometrial Cancer: Validation of the Cut-off Value of Ki67 as a Predictive Factor.

ObjectiveThe purpose of this study was to find a cut-off value of the immunohistochemical parameter Ki67 for stage I–II endometrial cancer.Materials and MethodsThe clinicopathological data of 318 patients with stages I–II endometrial cancer who received primary surgical treatment were retrospectively analyzed. A cut-off value of Ki67 for predicting recurrence of endometrial cancer was determined by using the receiver operating characteristic curve and the Youden index. The Cox regression was performed to screen factors associated with recurrence of endometrial cancer. Based on the cut-off value of Ki67, the patients were divided into two groups, and the differences of clinicopathological parameters between the two groups were compared.ResultsThe receiver operating characteristic curve showed that the optimal cut-off value of Ki67 for predicting recurrence of patients with stages I–II endometrial cancer was 38%. The multivariate Cox regression analysis demonstrated that the histotypes (P=0.012), myometrial invasion (P=0.014), cervical stromal invasion (P=0.001), Ki67 (P=0.002), estrogen receptor (ER) (P=0.045) and P53 (P=0.032) were significant prognostic predictors for recurrence of endometrial cancer. The recurrence-free survival and the disease-specific survival of patients in the high-Ki67 group (Ki67 ≥38%) were much lower than those in the low-Ki67 group (Ki67 <38%) (P=0.000, P=0.001, respectively). Among the 118 patients with early low-risk endometrial cancer who did not receive adjuvant treatment after surgery, the recurrence-free survival of patients in the high-Ki67 group was also lower than those in the low-Ki67 group (P=0.000).ConclusionThe Ki67 was demonstrated to be a useful prognostic factor in patients with stages I–II endometrial cancer, and the Ki67 labeling index 38.0% was optimal cut-off value for predicting recurrence.

44P - Prognostic value of Ki-67 in patients with triple-negative breast cancer receiving neo-adjuvant or adjuvant chemotherapy: A systematic review and meta-analysis

44P - Prognostic value of Ki-67 in patients with triple-negative breast cancer receiving neo-adjuvant or adjuvant chemotherapy: A systematic review and meta-analysis

Predictive value of the proliferation marker Ki-67 in patients with acute leukemia undergoing hematopoietic stem cell transplantation

Introduction Hematopoietic stem cell transplantation (HSCT) is increasingly used in cases of acute leukemia. Ki-67 protein is an excellent marker of proliferation in many solid tumors and hematological malignancies. Aim The aim was to evaluate the utility of Ki-67 as a prognostic marker before HSCT. Patients and methods The study included 40 adult Egyptian patients with acute leukemia undergoing HSCT. Plasma Ki-67 levels were measured by enzyme-linked immunosorbent assay before transplant and after (at the date of engraftment or day 30 if engraftment failure occurred). Results The median levels and (range) of plasma Ki-67 before and after transplant were 1.85±5.48 and 1.19±3.22 ng/ml, respectively. We found higher plasma Ki-67 levels (before and after transplant were correlated with more delayed engraftment (r=0.425,P=0.007 before transplant; r= 0.361 P=0.024 after transplant), and more prolonged neutropenic fever duration (r=0.377, P=0.017 before transplant; r=0.387, P=0.014 after transplant). Patients having acute graft-versus-host disease (GVHD) during the first month of HSCT also had higher levels of plasma Ki-67 before and after HSCT compared with patients who did not develop acute GVHD, with median (range) of 15.85 (0.20-27.40) ng/ml vs 0.30 (0.10-1.70) ng/ml (P=0.029) before transplant and 6.15 (3.90-18.90) ng/ml vs 0.20 (0.10-2.80) ng/ml (P= 0.001) after transplant. Plasma Ki-67 levels of greater than or equal to 6.4 ng/ml before transplantation (75% sensitivity and 100% specificity) and greater than or equal to 3.35 ng/ml after transplantation (100% sensitivity and specificity) are predictive values for detection of occurrence of acute GVHD. Conclusion High levels of plasma Ki-67 in patients with acute leukemia undergoing HSCT may be a predictor of delayed engraftment, prolonged neutropenic fever and occurrence of acute GVHD.

Multi-institutional validation of the predictive value of Ki-67 in patients with high-grade urothelial carcinoma of the upper urinary tract.

Multi-institutional validation of the predictive value of Ki-67 in patients with high-grade urothelial carcinoma of the upper urinary tract.

Multi-institutional validation of the predictive value of Ki-67 in patients with high-grade urothelial carcinoma of the upper urinary tract.

371 Background: To validate the independent predictive value of Ki-67 in patients with high-grade upper tract urothelial carcinoma (UTUC). Methods: 475 patients from the international UTUC collaboration who underwent extirpative surgery for high-grade UTUC were included in this study. Immunohistochemical staining for Ki-67 was performed on tissue microarray (TMA) formed from this patient cohort. Ki-67 expression was assessed in a semi-quantitative fashion and considered overexpressed at a cut-off of 20%. Multivariate analyses (MVA) were performed to assess independent predictors of oncological outcomes and Harrell’s C indices (HCI) were calculated for predictive models. Results: Median age of the cohort was 69.7 years and 55.2% of patients were male. Ki-67 was overexpressed in 25.9% of patients. Ki-67 overexpression was significantly associated with ureteral tumor location, higher pT-stage, lymphovascular invasion, sessile tumor architecture, tumor necrosis, concomitant carcinoma in situ (CIS), and regional lymph node metastases. In Kaplan-Meier analyses, overexpressed Ki-67 was associated with worse recurrence-free (RFS) (HR 12.6, p&lt;0.001) and cancer-specific survival (CSS) (HR 15.8, p&lt;0.001). In MVA, Ki-67 was an independent predictor of RFS (HR 1.6, 95% CI 1.07-2.30, p=0.021) and CSS (HR 1.9, 95% CI 1.29-2.90, p=0.001). Ki-67 improved HCI from 0.66 to 0.70 (p&lt;0.0001) for both RFS and CSS in our preoperative model, and from 0.81 to 0.82 (p=0.0018) for RFS and 0.81 to 0.83 (p=0.005) for CSS in our post-operative model. Conclusions: Ki-67 was validated as an independent prognostic predictor of RFS and CSS in patients treated with extirpative surgery for high-grade UTUC in a large, multi-institutional cohort.

This Month in Adult Urology

No AccessJournal of UrologyThis Month in Adult Urology1 May 2015This Month in Adult Urology William D. Steers William D. SteersWilliam D. Steers More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.01.108AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "This Month in Adult Urology." The Journal of Urology, 193(5), pp. 1455–1456 References 1 : A genomic algorithm for the molecular classification of common renal cortical neoplasms: development and validation. J Urol2015; 193: 1479. Link, Google Scholar 2 : Comparison of baseline urological symptoms in men and women in the MAPP Research Cohort. J Urol2015; 193: 1554. Link, Google Scholar 3 : Multi-institutional validation of the predictive value of Ki-67 in patients with high grade urothelial carcinoma of the upper urinary tract. J Urol2015; 193: 1486. Link, Google Scholar 4 : Mortality after radical cystectomy: impact of obesity versus adiposity after adjusting for skeletal muscle wasting. J Urol2015; 193: 1507. Link, Google Scholar 5 : Impact of the U.S. Preventive Services Task Force recommendations against prostate specific antigen screening on prostate biopsy and cancer detection rates. J Urol2015; 193: 1519. Link, Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 5May 2015Page: 1455-1456 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information William D. Steers More articles by this author Expand All Advertisement PDF downloadLoading ...

Multi-institutional Validation of the Predictive Value of Ki-67 in Patients with High Grade Urothelial Carcinoma of the Upper Urinary Tract

We validate the independent predictive value of Ki-67 in patients with high grade upper tract urothelial carcinoma. A total of 475 patients from the international Upper Tract Urothelial Carcinoma Collaboration who underwent extirpative surgery for high grade upper tract urothelial carcinoma were included in this study. Immunohistochemical staining for Ki-67 was performed on tissue microarray formed from this patient cohort. Ki-67 expression was assessed in a semiquantitative fashion and considered over expressed at a cutoff of 20%. Multivariate analyses were performed to assess independent predictors of oncologic outcomes and Harrell's C indices were calculated for predictive models. The median age of the cohort was 69.7 years and 55.2% of patients were male. Ki-67 was over expressed in 25.9% of patients. Ki-67 over expression was significantly associated with ureteral tumor location, higher pT-stage, lymphovascular invasion, sessile tumor architecture, tumor necrosis, concomitant carcinoma in situ and regional lymph node metastases. On Kaplan-Meier analyses over expressed Ki-67 was associated with worse recurrence-free survival (HR 12.6, p <0.001) and cancer specific survival (HR 15.8, p <0.001). On multivariate analysis Ki-67 was an independent predictor of recurrence-free survival (HR 1.6, 95% CI 1.07-2.30, p=0.021) and cancer specific survival (HR 1.9, 95% CI 1.29-2.90, p=0.001). Ki-67 improved Harrell's C index from 0.66 to 0.70 (p <0.0001) for recurrence-free survival as well as cancer specific survival in our preoperative model, and from 0.81 to 0.82 (p=0.0018) for recurrence-free survival and 0.81 to 0.83 (p=0.005) for cancer specific survival in our postoperative model. Ki-67 was validated as an independent predictor of recurrence-free survival and cancer specific survival in patients treated with extirpative surgery for high grade upper tract urothelial carcinoma in a large, multi-institutional cohort.

A study of Ki-67 labeling index in invasive nonmetastatic breast carcinoma.

e14001 Background: This study evaluates the predictive value of Ki-67 in patients with invasive breast cancer receiving neoadjuvant chemotherapy (NACT) and its correlation with established prognostic factors. Methods: This is a prospective observational study of 165 invasive nonmetastatic breast cancer patients. Clinicopathological characteristics and Ki-67 labeling index were assessed. Patients with locally advanced breast carcinoma (LABC) received NACT and response rates were evaluated. Statistical significance was calculated using Chi Square test, unpaired t test, and non-parametric Mann-Whitney test. Results: Amongst the Ki-67 high group a significantly large majority of patients had grade 3 tumor (86.8% vs. 13.1%, p value < 0.001), ER negativity (56.8% vs. 11.4% p value < 0.001), PR negativity (65.3% vs. 18.6%, p value < 0.001), HER2/neu overexpression (47.4 % vs11.4 % , p value < 0.001) and lymphovascular invasion (LVI) (29.4% vs. 14.7% p value= 0.024). In high Ki-67 group 24.3% achieved CR compared...

Prospective Analysis of Ki-67 as an Independent Predictor of Oncologic Outcomes in Patients with High Grade Upper Tract Urothelial Carcinoma

We determined the association of the proliferation marker Ki-67 with pathological parameters and oncologic outcomes in patients with high grade upper tract urothelial carcinoma. Immunohistochemical staining for Ki-67 was done prospectively in 101 consecutive patients undergoing radical nephroureterectomy/ureterectomy for high grade upper tract urothelial carcinoma. Data were compared based on Ki-67 status (normal vs over expressed). Survival was assessed by the Kaplan-Meier method. Cox regression analysis was done to identify independent predictors of time dependent outcomes. Median patient age was 70.0 years and median followup was 22.0 months (range 1 to 77). Overall, 30.2% of the population experienced recurrence and 24.8% died of upper tract urothelial carcinoma. Organ confined disease (T2 or less and lymph node negative), lymphovascular invasion and sessile architecture were present in 56.3%, 33.3% and 20.8% of patients, respectively. Ki-67 was over expressed in 73.3% of patients and associated with adverse pathological features. Patients with over expressed Ki-67 had significantly worse recurrence-free survival (43.2 vs 69.0 months, p = 0.006) and cancer specific survival (48.9 vs 68.9 months, p = 0.031) than patients with normal Ki-67. Patients with nonmetastatic disease similarly had worse recurrence-free survival (40.7 vs 71.8 months, p = 0.003) and cancer specific survival (41 months vs not attained, p = 0.008) for over expressed vs normal Ki-67. After adjusting for the effects of organ vs nonorgan confined disease Ki-67 over expression was an independent predictor of recurrence-free survival in the total cohort (HR 4.3, p = 0.05) and in patients with nonmetastatic disease (HR 8.5, p = 0.038). Ki-67 over expression was associated with adverse pathological features in cases of upper tract urothelial carcinoma. It was also an independent predictor of recurrence-free survival in patients with high grade upper tract urothelial carcinoma.

Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment

BackgroundThe pathological complete response (pCR) after neoadjuvant chemotherapy is a surrogate marker for a favorable prognosis in breast cancer patients. Factors capable of predicting a pCR, such as the proliferation marker Ki67, may therefore help improve our understanding of the drug response and its effect on the prognosis. This study investigated the predictive and prognostic value of Ki67 in patients with invasive breast cancer receiving neoadjuvant treatment for breast cancer.MethodsKi67 was stained routinely from core biopsies in 552 patients directly after the fixation and embedding process. HER2/neu, estrogen and progesterone receptors, and grading were also assessed before treatment. These data were used to construct univariate and multivariate models for predicting pCR and prognosis. The tumors were also classified by molecular phenotype to identify subgroups in which predicting pCR and prognosis with Ki67 might be feasible.ResultsUsing a cut-off value of > 13% positively stained cancer cells, Ki67 was found to be an independent predictor for pCR (OR 3.5; 95% CI, 1.4, 10.1) and for overall survival (HR 8.1; 95% CI, 3.3 to 20.4) and distant disease-free survival (HR 3.2; 95% CI, 1.8 to 5.9). The mean Ki67 value was 50.6 ± 23.4% in patients with pCR. Patients without a pCR had an average of 26.7 ± 22.9% positively stained cancer cells.ConclusionsKi67 has predictive and prognostic value and is a feasible marker for clinical practice. It independently improved the prediction of treatment response and prognosis in a group of breast cancer patients receiving neoadjuvant treatment. As mean Ki67 values in patients with a pCR were very high, cut-off values in a high range above which the prognosis may be better than in patients with lower Ki67 values may be hypothesized. Larger studies will be needed in order to investigate these findings further.