Khan Qamar J, Kimler Bruce F, O'Dea Anne P, Zalles Carola M, Sharma Priyanka, Fabian Carol J
University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA.
Breast Cancer Res. 2007;9(3):R35. doi: 10.1186/bcr1683.
Ki-67 expression is a possible risk biomarker and is currently being used as a response biomarker in chemoprevention trials. Mammographic breast density is a risk biomarker and is also being used as a response biomarker. We previously showed that Ki-67 expression is higher in specimens of benign breast cells exhibiting cytologic atypia that are obtained by random periareolar fine needle aspiration (RPFNA). It is not known whether there is a correlation between mammographic density and Ki-67 expression in benign breast ductal cells obtained by RPFNA.
Included in the study were 344 women at high risk for developing breast cancer (based on personal or family history), seen at The University of Kansas Medical Center high-risk breast clinic, who underwent RPFNA with cytomorphology and Ki-67 assessment plus a mammogram. Mammographic breast density was assessed using the Cumulus program. Categorical variables were analyzed by chi2 test, and continuous variables were analyzed by nonparametric test and linear regression.
Forty-seven per cent of women were premenopausal and 53% were postmenopausal. The median age was 48 years, median 5-year Gail Risk was 2.2%, and median Ki-67 was 1.9%. The median mammographic breast density was 37%. Ki-67 expression increased with cytologic abnormality (atypia versus no atypia; P <or= 0.001) and younger age (<or=50 years versus >50 years; P <or= 0.001). Mammographic density was higher in premenopausal women (P <or= 0.001), those with lower body mass index (P < 0.001), and those with lower 5-year Gail risk (P = 0.001). Mammographic density exhibited no correlation with Ki-67 expression or cytomorphology.
Given the lack of correlation of mammographic breast density with either cytomorphology or Ki-67 expression in RPFNA specimens, mammographic density and Ki-67 expression should be considered as potentially complementary response biomarkers in breast cancer chemoprevention trials.
Ki-67表达是一种可能的风险生物标志物，目前在化学预防试验中用作反应生物标志物。乳腺钼靶密度是一种风险生物标志物，也被用作反应生物标志物。我们之前表明，通过随机乳晕周围细针穿刺（RPFNA）获得的表现出细胞学异型性的良性乳腺细胞标本中Ki-67表达较高。目前尚不清楚通过RPFNA获得的良性乳腺导管细胞中乳腺钼靶密度与Ki-67表达之间是否存在相关性。
该研究纳入了344名患乳腺癌风险较高（基于个人或家族史）的女性，她们在堪萨斯大学医学中心高危乳腺诊所就诊，接受了RPFNA检查，并进行了细胞形态学和Ki-67评估以及乳腺钼靶检查。使用Cumulus程序评估乳腺钼靶密度。分类变量采用卡方检验进行分析，连续变量采用非参数检验和线性回归进行分析。
47%的女性处于绝经前，53%处于绝经后。中位年龄为48岁，中位5年盖尔风险为2.2%，中位Ki-67为1.9%。乳腺钼靶密度中位数为37%。Ki-67表达随细胞学异常（异型性与无异型性；P≤0.001）和年龄较小（≤50岁与＞50岁；P≤0.001）而增加。绝经前女性的乳腺钼靶密度较高（P≤0.001），体重指数较低的女性（P＜0.001）以及5年盖尔风险较低的女性（P = 0.001）也是如此。乳腺钼靶密度与Ki-67表达或细胞形态学无相关性。
鉴于在RPFNA标本中乳腺钼靶密度与细胞形态学或Ki-67表达均无相关性，在乳腺癌化学预防试验中，乳腺钼靶密度和Ki-67表达应被视为潜在的互补反应生物标志物。
