The diagnostic and prognostic values of Ki-67/MIB-1 expression in thyroid cancer: a meta-analysis with 6,051 cases

Abstract

BackgroundGrowing evidence has demonstrated that Ki-67/MIB-1 has an effect on the clinical progression and prognosis in cancers. However, the diagnostic and prognostic values of Ki-67/MIB-1 in thyroid cancer remain unclear.Materials and methodsThe meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were retrieved from PubMed, EBSCO, EMBASE, ISI Web of Science, China National Knowledge Infrastructure, WanFang and Chinese VIP databases. MetaDiSc and STATA12.0 were used to analyze the meta-analysis. Fixed-effect analysis and random-effect analysis were applied to pool the relative ratio based on heterogeneity in this meta-analysis.ResultsIn the meta-analysis, 51 eligible studies were included. The pooled sensitivity of Ki-67/MIB-1 was 0.61 (95% confidence interval [CI]: 0.59–0.63) and specificity was 0.75 (95% CI: 0.74–0.77) in thyroid cancer. The pooled positive likelihood ratio was 3.19 (95% CI: 2.30–4.42) and negative likelihood ratio was 0.43 (95% CI: 0.35–0.54). In the diagnosis of thyroid cancer, the pooled diagnostic odds ratio of Ki-67/MIB-1 was 8.54 (95% CI: 5.03–14.49). The area under the symmetric receiver operating characteristic curve was 0.804 (standard error =0.031). Our results showed that there were statistical associations between Ki-67/MIB-1 and age (odds ratio [OR] =1.71, 95% CI: 1.14–2.57, P=0.010), tumor size (OR =1.86, 95% CI: 1.17–2.96, P=0.008), lymph node metastasis (OR =2.49, 95% CI: 1.42–4.39, P=0.002), metastasis status (OR =6.96, 95% CI: 2.46–19.69, P<0.001), tumor node metastasis stage (OR =6.56, 95% CI: 3.80–11.34, P<0.001) and extrathyroid extension (OR =1.91, 95% CI: 1.27–2.87, P=0.002). Furthermore, thyroid cancer patients with a high level of Ki-67/MIB-1 had a worse disease-free survival as compared to patients with a low level of Ki-67/MIB-1 (hazard ratio =5.19, 95% CI: 3.18–8.46, P<0.001). Also, Ki-67/MIB-1 was found to be associated with increased risk of mortality (hazard ratio =3.56, 95% CI: 1.17–10.83, P=0.025).ConclusionOur results demonstrated that Ki-67/MIB-1 might act as a potential factor in diagnosing thyroid cancer in Chinese. Also, the meta-analysis indicated that Ki-67/MIB-1 might have an effect on prognosis in non-Chinese thyroid cancer patients.

Aggressive cribriform‐morular variant of papillary thyroid carcinoma: Report of an unusual case with pulmonary metastasis displaying poorly differentiated features

“…The value of the Ki‐67 labeling index in CMV‐PTC cases is usually low, less than 6%; however, two of three cases of metastatic CMV‐PTC showed a high Ki‐67 labeling index. Previous reports indicated that a high Ki‐67 labeling index correlated with distant metastasis and an unfavorable prognosis . In our case, the Ki‐67 labeling indexes of thyroid (primary) and lung (metastasis) tumors were 40.2% and 22.1%, respectively; notably, the thyroid tumor in this study led to multiple lung metastases.…”

Reduced expression of oestrogen receptor‐β is associated with tumour invasion and metastasis in oestrogen receptor‐α‐negative human papillary thyroid carcinoma

“…; Pan et al . ). However, there was no significant difference of Ki‐67 expression between patients with tumour size ≤2 cm and >2 cm ( Z = −0.309, P = 0.757).…”

“…; Pan et al . ). In this study, we did not find an association between ERβ1 and Ki‐67, which was consistent with our previous findings (Huang et al .…”

ADAM protein family – its role in tumorigenesis, mechanisms of chemoresistance and potential as diagnostic and prognostic factors

“…The Ki67 proliferation index is widely used to assess the grade of tumor histological malignancy. This is correlated with cancer patient cell proliferation, time to recurrence and shorter survival rate [76]. Ki67 and the histological tumor grade are also correlated with changes in phenotype of lymph node metastases compared to the primary tumor, together with certain molecular markers associated with malignancy and a poorer prognosis [77].…”