Cutoff of 25% for Ki67 expression is a good classification tool for prognosis in colorectal cancer in the AJCC‑8 stratification

Abstract

Ki-67 expression has been widely used in clinical practice as an index to evaluate the proliferative activity of tumor cells. The cutoff for Ki67 expression in order to increase the prognostic value of Ki67 expression in colorectal cancer varies. The present study assessed the relationship between the 25% cutoff for Ki67 expression and prognosis in colorectal cancer in the AJCC-8 (American Joint Committee on Cancer 8 edition) stratification. The current trial included 1,090 colorectal cancer patients enrolled from 2006 to 2012 at Huzhou Central Hospital. Ki67 expression was classified according to 25% intervals, dividing the patients into four groups. Measurement data were analyzed by ANOVA, and count data by Crosstabs. Bivariate correlation analysis was performed to assess clinicopathological indicators based on Ki67 expression. Disease-free survival (DFS) and overall survival (OS) based on Ki67 levels were analyzed by the Kaplan-Meier method. A total of 1,090 patients of the 2,080 enrolled CRC cases were evaluated (52.4%). Invasive depth, tumor differentiation, tumor size, AJCC-8, positive number of lymph nodes and chemotherapy status showed significant differences in the various Ki67 expression groups (all P<0.05), with significant correlations (Spearman rho: 0.170, 0.456, 0.22, 0.195, 0.514 and-0.201, respectively, all P<0.001). DFS and OS for the different Ki67 level groups based on AJCC-8 stratification were analyzed, and no significance was found in stage IV (P= 0.334). DFS and OS survival rates were assessed at different Ki67 expression levels, and no significant differences were found (all P>0.05). Cox regression analysis showed that invasive depth, lymph node metastasis, tumor differentiation, AJCC-8 and Ki67 were independent factors affecting colorectal cancer (P= 0.030, all others P<0.001). In conclusion, a cutoff of 25% for Ki67 expression is a good classification tool. High Ki67 has a close association with poor prognosis in colorectal cancer and independently predicts prognosis in the AJCC-8 stratification.

A Noninvasive Assessment of Tumor Proliferation in Lung cancer Patients using Intravoxel Incoherent Motion Magnetic Resonance Imaging

“…In this study, we evaluated the associations between the DWI, IVIM, DKI parameters, and Ki-67 proliferation in tumor tissues of patients with lung cancer. We selected a cut-off of 25% for Ki-67 expression to differentiate the low and high Ki-67 groups 34 . We found that D values from IVIM were negatively correlated with Ki-67 expression (Spearman's coefficient r = -0.76).…”

Clinical significance of proliferation index and E-cadherin expression in colorectal adenocarcinoma

“…In this study, we observed that low proIDX has a good correlation coefficient significantly associated with pT1 and pT2 stages, while high proIDX is associated with significant and high correlation coefficients to lymph vessel invasion, blood vessel invasion, neural invasion, lymph node metastases and distant metastases. In a recent study by Tong et al 2020, a sample of 1,090 subjects with colorectal cancer observed a significant association of Ki67 expression with pT stage, histological grade, AJCC stage, and lymph node metastases [15].…”

An integrated mass spectrometry imaging and digital pathology workflow for objective detection of colorectal tumours by unique atomic signatures

“… 44,45 The non-histone nuclear protein is expressed throughout the active phase of cell cycle, and increased expression in tumours above a 25% cut-off is associated with higher levels of cell proliferation in colorectal cancer. 46 …”

“…44,45 The non-histone nuclear protein is expressed throughout the active phase of cell cycle, and increased expression in tumours above a 25% cut-off is associated with higher levels of cell proliferation in colorectal cancer. 46 The NIW image (Fig. 4A) showed sparse clusters of positive pixels, and when overlaid on the adjacent H&E section it was conrmed these areas did not correspond to any visible invasion of the submucosa required to meet the standard histopathological classication of a T1 primary tumour.…”