Hu Yue, Gu Ran, Zhao Jinghua, Yang Yaping, Liu Fengtao, Jin Liang, Chen Kai, Jia Haixia, Wang Hongli, Liu Qiang, Su Fengxi, Jia Weijuan
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China.
Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510288, People's Republic of China.
BMC Cancer. 2017 Jan 6;17(1):28. doi: 10.1186/s12885-016-3021-7.
This study evaluated the distribution pattern of the Ki67-labeling index (LI) among patients at a Chinese breast cancer center, and analyzed its prognostic significance in the 2015 St Gallen consensus breast cancer classification, estrogen receptor-positive and human epidermal growth factor receptor 2-negative(ER/HER2)subtype.
We classified 939 women with ER/HER2 breast cancer into three groups by Ki67-LI levels, and followed their clinicopathologic characteristics and prognoses.
In the 939 eligible subjects, 342 had Ki67-LI ≤10% (Ki67), 281 had Ki67-LI between 10 and 30% (Ki67), and 316 had Ki67-LI ≥30% (Ki67). Although the Ki67 group had less favorable clinicopathologic factors, the Ki67 group's factors varied considerably. Kaplan-Meier estimates showed that disease-free survival(DFS) for the Ki67 group was significantly shorter than the Ki67 group but longer than the Ki67 group. Ki67-LI had independent prognostic significance in multivariate analysis. Other diagnostic factors, including tumor size >2 cm, positive lymph nodes, and grade III disease, were significantly associated with poorer disease-free survival only in the Ki67 group.
For patients with ER/HER2 breast cancer, we confirmed three distinct risk patterns by Ki67-LI levels according to the 2015 St Gallen consensus. For patients with clearly low or high Ki67-LI, straightforward clinical decisions could be offered, but for patients with intermediate Ki67-LI, other factors might provide valuable information.
本研究评估了中国一家乳腺癌中心患者中Ki67标记指数（LI）的分布模式，并分析了其在2015年圣加仑共识乳腺癌分类中雌激素受体阳性和人表皮生长因子受体2阴性（ER/HER2）亚型中的预后意义。
我们根据Ki67-LI水平将939例ER/HER2乳腺癌女性患者分为三组，并跟踪其临床病理特征和预后。
在939名符合条件的受试者中，342例Ki67-LI≤10%（Ki67低组），281例Ki67-LI在10%至30%之间（Ki67中组），316例Ki67-LI≥30%（Ki67高组）。尽管Ki67低组的临床病理因素不太有利，但Ki67中组的因素差异很大。Kaplan-Meier估计显示，Ki67高组的无病生存期（DFS）明显短于Ki67低组，但长于Ki67中组。Ki67-LI在多变量分析中具有独立的预后意义。其他诊断因素，包括肿瘤大小>2 cm、淋巴结阳性和III级疾病，仅在Ki67高组中与较差的无病生存期显著相关。
对于ER/HER2乳腺癌患者，根据2015年圣加仑共识，我们通过Ki67-LI水平确认了三种不同的风险模式。对于Ki67-LI明显低或高的患者，可以提供直接的临床决策，但对于Ki67-LI中等的患者，其他因素可能提供有价值的信息。
