Kobayashi Takayuki, Iwaya Keiichi, Moriya Tomoyuki, Yamasaki Tamio, Tsuda Hitoshi, Yamamoto Junji, Matsubara Osamu
Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
BMC Clin Pathol. 2013 Feb 6;13:5. doi: 10.1186/1472-6890-13-5.
Ki67 is widely used in order to distinguish the "A" and "B" subtypes of luminal-type breast cancer. This study aimed to validate the prognostic value of adding p53 to Ki67 for characterizing luminal-type breast cancer.
Immunostaining for Ki67, p53, and the molecular markers HER2, CK5/6, CK14, EGFR, FOXA1, GATA3, and P-cadherin was examined hormone receptor (HR)-positive cancer tissues from 150 patients. The prognostic value of an immunohistochemical panel comprising Ki67 and p53 was compared with that of the single Ki67 labeling index (LI), and uni- and multivariate analyses were performed.
Division of the patients based on the immunohistochemistry results into favorable- (low Ki67 LI, p53-negative) and unfavorable- (high Ki67 LI and/or p53-positive) phenotype groups yielded distinctly different Kaplan-Meier's curves of both disease-free (P<0.0001) and overall survival (P=0.0007). These differences were much more distinct than those between the corresponding low Ki67 LI vs. high Ki67LI curves. While the prognostic values of the other molecular markers were not significant, combined Ki67-p53 status was an independent prognostic factor by multivariate analysis.
These data indicate that an immunohistochemical panel comprising Ki67 and p53 is a practical tool for management of patients with HR-positive breast cancer.
Ki67被广泛用于区分管腔型乳腺癌的“A”和“B”亚型。本研究旨在验证在Ki67基础上增加p53对管腔型乳腺癌进行特征化的预后价值。
对150例激素受体(HR)阳性癌组织进行Ki67、p53以及分子标志物HER2、CK5/6、CK14、EGFR、FOXA1、GATA3和P-钙黏蛋白的免疫染色检测。将包含Ki67和p53的免疫组化指标的预后价值与单一Ki67标记指数(LI)的预后价值进行比较,并进行单因素和多因素分析。
根据免疫组化结果将患者分为预后良好组(低Ki67 LI,p53阴性)和预后不良组(高Ki67 LI和/或p53阳性),两组的无病生存期(P<0.0001)和总生存期(P=0.0007)的Kaplan-Meier曲线有明显差异。这些差异比相应的低Ki67 LI与高Ki67 LI曲线之间的差异更为明显。虽然其他分子标志物的预后价值不显著,但多因素分析显示联合Ki67-p53状态是一个独立的预后因素。
这些数据表明,包含Ki67和p53的免疫组化指标是HR阳性乳腺癌患者管理的实用工具。