Ki-67 expression predicts biochemical recurrence after radical prostatectomy in the setting of positive surgical margins

Abstract

BackgroundPositive surgical margin (PSM) is a predictor of biochemical recurrence (BCR) following radical prostatectomy (RP). Attempts to stratify PSM based on linear length, Gleason score, location and number have failed to add to predictive models using margin status alone. We evaluated the prognostic significance of Ki-67 expression in this setting.MethodsImmunohistochemical staining for Ki-67 was done on prostatectomy specimens from 117 patients who had a PSM. Ki67 expression was measured at the margin and in the index lesion. Patients were dichotomized based on Ki-67 expression into three groups. Group 1 with no Ki-67 expression, Group 2 with Ki-67 ≤ 2%, and Group 3 with Ki-67 ≥ 3%.To eliminate the impact of the adjuvant treatment (AT) on the outcome, data were analyzed by the Cox proportional hazards in which AT was Considered as a time-dependent covariate.ResultsThe discordance rate of Ki-67 expression between matched index lesion and margin specimens was 44/117 (37.6%). There was a trend for higher risk of BCR (HR:2.06, (0.97–4.43), P = 0.06) in patients expressing high Ki67 at the surgical margin although this was not statistically significant. However High Ki-67 expression in the index lesion was an independent predictive factor for BCR in this subset of patients. (HR:4, (1.64–9.80), P = 0.002).ConclusionHigh Ki67 expression in the index prostate cancer lesion is an independent predictor of BCR in patients with positive surgical margin following radical prostatectomy. Our findings need to be validated in a larger cohort.

Ki-67 and CK-19 are predictors of locoregional recurrence in papillary thyroid carcinoma

“…Ki-67 is a DNA-binding protein that is found primarily in the nucleus and is related to cell proliferation, being an important tumour marker. Its high immunoexpression is associated with worse prognosis in breast cancer and prostate cancer 31,32 . In thyroid, few studies have analysed the use of this marker as a prognostic factor.…”

A Novel Artificial Intelligence–Powered Method for Prediction of Early Recurrence of Prostate Cancer After Prostatectomy and Cancer Drivers

“…The validity of the ROIs was further confirmed by the significant differences in the expressions of AR, PSA, and PSMA in addition to CC3, Ki67, and PD-L1 between PCa-t and BPT, which were in concordance with the previously published studies. [28][29][30][31][32] We recognize that these observations were made in a small sample set. However, achieving statistical significance in the small sample set gives us confidence that a larger sample set will further strengthen the validation.…”

Value of three-dimensional visualization of preoperative prostatic magnetic resonance imaging based on measurements of anatomical structures in predicting positive surgical margin after radical prostatectomy

“…Tumor-specific characteristics including prostate volume, T stage and Gleason score exposed significant notable association with PSM ( 18 , 19 ). As the evolving progress of reliable prognostic biomarkers in urological cancer, increasing number of biomarkers for predicting PSM have been discovered ( 2 ): immunohistochemical staining for Ki-67 may indicate high risk of biochemical recurrence in patients with PSM after radical prostatectomy ( 20 ). Meanwhile, moderate or strong heterogeneous nuclear ribonucleoprotein A1 (hnRNPA1) immunostaining was relevant to positive surgical margin and adverse tumor features ( 21 ).…”