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Prognostic impact of Ki-67 in patients with gastric cancer—the importance of depth of invasion and histologic differentiation
- Source :
- Medicine
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Supplemental Digital Content is available in the text<br />Ki-67 protein is a cellular marker for proliferation. The role of Ki-67 as a prognostic biomarker has not been established in gastric cancer. The present study was performed to investigate the significance of Ki-67 expression as a biomarker in early gastric cancer (EGC). With tissue microarray for 320 patients with gastric cancer, we performed immunohistochemical staining for Ki-67. Its clinical significance was analyzed with adjustment via the propensity score-matching. For validation, we performed bootstrap resampling. The median follow-up duration was 72 months (range: 3–120 months). Ki-67-high group showed worse prognosis than Ki-67-low group in EGC (5-YSR, 78.9% vs 92.0%, P = .018), but not in advanced gastric cancer (AGC) (5-YSR, 58.5% vs 59.2%, P = .951). Interestingly, in the patients with well-differentiated histology, prognosis for Ki-67-high group was considerably worse than that for Ki-67-low group (5-YSR, 67.0% vs 94.4%, P = .012), but not in those with moderately differentiated (P = .504) and poorly differentiated histology (P = .905). In this cohort, there was a strong correlation between the proportion of EGC and well-differentiated histology (r = 0.215, P = .002). Multivariate analysis also revealed that the high-Ki-67 expression serves as a poor prognostic factor in EGC (HR 4.346, 95% CI 1.397–13.515, P = .011), especially in the well-differentiated histology, but not in all the patients (P = .171). Bootstrap resampling internally validated this result (P = .011). This study suggests that Ki-67 expression may be a good biomarker for prognosis prediction for EGC with well-differentiated histologic type.
- Subjects :
- Adult
Male
Pathology
medicine.medical_specialty
Observational Study
Kaplan-Meier Estimate
Young Adult
03 medical and health sciences
0302 clinical medicine
Stomach Neoplasms
Biomarkers, Tumor
Humans
Medicine
Neoplasm Invasiveness
In patient
early gastric cancer
Young adult
Propensity Score
advanced gastric cancer
Aged
Aged, 80 and over
biology
business.industry
Cancer
General Medicine
Middle Aged
Prognosis
medicine.disease
Immunohistochemistry
Early Gastric Cancer
Ki-67 Antigen
Tissue Array Analysis
Depth of invasion
030220 oncology & carcinogenesis
Ki-67
Multivariate Analysis
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Disease Progression
biology.protein
Cancer research
Biomarker (medicine)
Female
030211 gastroenterology & hepatology
business
Follow-Up Studies
Research Article
Subjects
Details
- ISSN :
- 00257974
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi.dedup.....0ee20acaa4815f12f88531ee467288d8
- Full Text :
- https://doi.org/10.1097/md.0000000000007181