The prognostic and predictive potential of Ki-67 in triple-negative breast cancer

Zhu, Xiao Li; Chen, Li; Huang, Binhao; Wang, Yue; Ji, Lei; Wu, Jiong; Di, Gen-Hong; Li, Guangyu; Yu, Ke-Da; Shao, Zhimin; Wang, Zhonghua

doi:10.1038/s41598-019-57094-3

Cited by 118 publications

(104 citation statements)

References 30 publications

(29 reference statements)

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“… 28 Studies showed a high level of Ki-67 was associated with severity of tumor and poor prognosis in breast cancer and Ki-67 could be used to indicate different prognosis and treatment in TNBC patients. 29 …”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Triple-Negative Breast Cancer in Southern Shaanxi Province, China

Xing

Fan

Gao

et al. 2021

CMAR

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Purpose Describing the clinical features of patients with breast cancer in an area is important to provide the information for the local oncologist to make sound treatment plans. In this study, we explored the clinical features of breast cancer patients in Southern Shaanxi Province, China. Patients and Methods A total of 328 breast cancer patients between 2010 and 2015 were recruited at our hospital. Patients’ clinical information and the results of the histopathological examination were collected. Independent sample t -test and Cox regression were used to analyze the data. Results The peak age onset of these patients was between 45 and 50. At diagnosis, 8.23% of patients were at clinical stage 1 and 29.57% were triple-negative breast cancer subtype. High expression of Ki-67 in these patients was found associated with triple-negative breast cancer. The 5-year survival rate in these patients was 66.4%, and the survival rate in stage 1 and 2 patients (88.2%) was significantly higher than that in stage 3 and4 (57.4%). Conclusion We here reported the clinical features of patients with breast cancer in Southern Shaanxi Province, China. The breast cancer patients in Southern Shaanxi Province showed a unique clinical feature.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Triple-Negative Breast Cancer in Southern Shaanxi Province, China

Xing

Fan

Gao

et al. 2021

CMAR

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“…Our prognostic model determined 60% as the cut-off value for Ki67 status, which was much higher than those in other studies (e.g., 14% and 20%) [18,[21][22][23][24]. We reckoned that this situation was because of a lack of a standardised procedure for Ki67 assessment and the controversial Ki67 assay interpretation [25], and it was also because of determining the cut-off value for Ki67 by the ROC method, an univariate analysis method in previous study [19,23]. So the prognostic value of Ki67 index in breast cancer was to be further explored.…”

Section: Discussionmentioning

confidence: 60%

An Extended Cox Prognostic Model of ER/PR+ and HER2− Breast Cancer Patients

XIE

CUI

Liu

et al. 2020

Preprint

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Background: The purpose of this study was to explore a new ER/PR+ and HER2− breast cancer prognostic model called the extended Cox prognostic model by us for determining the cut-off values for multiple continuous prognostic factors and their interaction via the new modeling idea and variable selection method. Methods: A total of 335 patients with ER/PR+, HER2- breast cancer were enrolled for the final analysis. The primary endpoint was breast cancer-specific mortality (BCSM). The prognostic factors (histological grade, histological type, stage, T, N, lymphovascular invasion, P53, Ki67, ER, PR, age) were included in this study. The four continuous valuables (Ki67, ER, PR, age) were partitioned into a series of binary variables which all were fitted in the multivariate Cox analysis. A smoothly clipped absolute deviation (SCAD) variable selection method was used. Model performance was expressed in discrimination and calibration. Results: We developed an extended Cox model with a time threshold at 164 weeks (more than 3 years) post-operation. We found that the cut-off values for PR, Ki67 and age were 20%, 60% and 41-55 years respectively. There was interaction between age and PR for the patients with age≥41years and PR≥20% after 164 weeks post-operation. The patients with age≥41years and PR≥20% after 164 weeks post-operation had relatively higher mortality than before 164 weeks postoperatively. Conclusions: Our study would offer the guidance in the prognosis for the patients with ER/PR+ and HER2− breast cancer in China. The new idea would be one of ideas for modeling and determining the cut-off values of prognostic factors in future.

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“…This proved that staining intensity of Ki-67 has not signi cant values in OS prediction of patients with BC. Zhu pointed that that setting the critical value of Ki-67 index as 30% is an independent prognosis factor of OS and DFS of three-yin cancer [19]. Patients with triple negative cancer and Ki-67 > 30% had relatively poorer prognosis, especially for patients in Stage I.…”

Section: Discussionmentioning

confidence: 99%

Prognostic and Molecular Classification Value of Ki-67 Index in Patients With Breast Cancer

Wang¹,

Tian³

et al. 2020

Preprint

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Background: The Ki-67, which is a proliferative index, became more important in making treatment decisions of breast cancers. But a few factors limited its use in clinical practices, especially the assessment of positive cells percentage of Ki-67 and the cut-off value of Ki-67. In this study, we examined the expression of Ki-67 by immunohistochemical method, and evaluated the value of Ki-67 index in patients with breast cancers systematically.Methods: The expression of Ki-67 was detected by immunohistochemical method, the relationship between over-survive (OS), disease free survive (DFS) of patients with BCs and Ki-67 index，and the value of Ki-67 in molecular classification of BC were analyzed with SPSS ver. 18.0 and GraphPad Prism software.Results: There were markedly difference between OS in patients with BC when the Ki-67 index arranged from 46% to 68% (χ2 = 6.87, P = 0.0088; χ2 = 7.69, P = 0.0056 respectively), and the same results were also found when the positive density was added to the Ki-67 index, but the positive density has limited value in assessment the value of Ki-67. There were markedly difference between DFS in BCs when the Ki-67 index arranged from 50% to 58% (χ2 = 7.31, P = 0.0068; χ2 = 7.88, P = 0.005). When using 14% as a cut-off point to classify the molecular type of BC, the Luminal A-type patients had statistical differences with patients with HER-2 over-expression, with triple negative type BC in term of OS respectively (χ2 = 4.8, P = 0.028; χ2 = 3.89, P = 0.049). There’s statistical difference between OS of patients with HER-2 over-expression BC when the Ki-67 index fell in the range of 49%- 60% (χ2 =4.97, P = 0.0259; χ2 =5.61, P = 0.0178, respectively). There were statistical differences between the Luminal A-type BC and HER-2 over-expression BC in term of OS (χ2 = 4.65, P = 0.031) according to suggestions of the CSCO consensus in 2019, there were statistical differences between two groups of Luminal B HER-2 (-) type BCs when the Ki-67 index was 52% (χ2=6.61, P = 0.0101).Conclusions: Ki-67 index can be used to assess the OS and DFS of patients with BC, and the positive density of Ki-67 has little value in assessment of prognosis in patients with BC. Different molecular classification methods may influence the assessment of prognosis and the results of molecular type in patients with BC.

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The prognostic and predictive potential of Ki-67 in triple-negative breast cancer

Cited by 118 publications

References 30 publications

High Prevalence of Triple-Negative Breast Cancer in Southern Shaanxi Province, China

High Prevalence of Triple-Negative Breast Cancer in Southern Shaanxi Province, China

An Extended Cox Prognostic Model of ER/PR+ and HER2− Breast Cancer Patients

Prognostic and Molecular Classification Value of Ki-67 Index in Patients With Breast Cancer

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