Prognostic and clinicopathological role of high Ki-67 expression in patients with renal cell carcinoma: a systematic review and meta-analysis

Abstract

Previous studies have elevated the prognostic value of Ki-67 in renal cell carcinoma (RCC), but the reports are controversial and inconsistent. We conducted a systematic review and meta-analysis to clarify the significance of Ki-67 in RCC prognosis. We systematically searched PubMed, Web of Science, and Embase to identify relevant studies until April 2016. Based on the inclusion and exclusion criteria, 20 studies, including 5,398 patients, were eligible for further analysis. Results showed that high Ki-67 expression in RCC was associated with poor OS (HR = 1.95, 95% CI: 1.44–2.64), CSS (HR = 1.67, 95% CI: 1.47–1.89), and DFS (HR = 2.56, 95% CI: 1.79–3.67). In addition, high Ki-67 expression was significantly associated with TNM stage (III/IV vs. I/II: RR = 2.03, 95% CI: 1.68–2.44), pathological T stage (T3/T4 vs. T1/T2: RR = 1.67, 95% CI: 1.35–2.06), metastasis (yes vs. no: RR = 2.15, 95% CI: 1.77–2.62), and Fuhrman grade (III/IV vs. I/II: RR = 1.77, 95% CI: 1.20–2.60). Our study suggested that Ki-67 was a prognostic marker in RCC. High Ki-67 expression was correlated with poor prognosis and advanced clinicopathological features, and it could serve as a biomarker for disease management.

Analytical validation of a standardised scoring protocol for Ki67 immunohistochemistry on breast cancer excision whole sections: an international multicentre collaboration

“…The nuclear antigen recognised by the Ki67 antibody is expressed in proliferating cells but absent in resting cells . Since its discovery in 1983 by Gerdes et al , Ki67 assessed by immunostaining has been studied extensively as a prognostic and predictive marker, predominantly in hormone receptor‐positive breast cancer, but also in other tumours . For example, presurgical Ki67 has been shown to be a marker for recurrence‐free survival and, in the neoadjuvant setting, a marker for endocrine‐resistant tumour that may require more aggressive treatment .…”

“…1 Since its discovery in 1983 by Gerdes et al, 1 Ki67 assessed by immunostaining has been studied extensively as a prognostic [2][3][4][5][6][7][8][9][10][11] and predictive 4,6,9,12,13 marker, predominantly in hormone receptor-positive breast cancer, but also in other tumours. [14][15][16][17][18] For example, presurgical Ki67 has been shown to be a marker for recurrence-free survival 19 and, in the neoadjuvant setting, a marker for endocrine-resistant tumour that may require more aggressive treatment. 20 Excellent intra-observer reproducibility under controlled pre-analytical and staining conditions 21 has contributed to the body of evidence showing the potential of Ki67 immunohistochemistry assay to be implemented in hospital laboratories as a cost-effective part of clinical management.…”

A multivariate statistical analysis of the effects of styrene maleic acid encapsulated RL71 in a xenograft model of triple negative breast cancer

“…Article relationship between Ki67 and overall survival (OS) and disease-free survival (DFS) [33][34][35], the predictive value of Ki67 as an indicator of chemotherapy benefit is controversial. For example, in the BR9601 adjuvant chemotherapy trial, 8 cycles of CMF (cyclophosphamide, methotrexate and fluorouracil) or epirubicin-CMF (4 cycles of epirubicin, followed by four cycles of the same CMF regimen) were administered to patients every 21 d. The primary end point was relapse-free survival (RFS) (HR = 0.36) and OS (HR = 0.30).…”

Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis

“…10 Ki-67 exists in almost all phases of the cell cycle, including G1, S, G2, and M stages, except for the G0 stage. 11 The expression level of Ki-67 detected by immunohistochemical (IHC) staining is usually considered as an index that reflects the activity of cell proliferation. 12 Many studies have also reported the prognostic value of Ki-67 in a variety of solid tumors, such as non-small-cell lung cancer, 13 colorectal cancer, 14 bladder cancer, 15 and renal cell carcinoma.…”