Penault-Llorca Frederique, Radosevic-Robin Nina
Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France; Inserm/Univerisity of Auvergne UMR1240, Clermont-Ferrand, France; School of Medicine, University of Auvergne, Clermont-Ferrand, France.
Department of Surgical Pathology and Biopathology, Jean Perrin Comprehensive Cancer Centre, Clermont-Ferrand, France; Inserm/Univerisity of Auvergne UMR1240, Clermont-Ferrand, France.
Pathology. 2017 Feb;49(2):166-171. doi: 10.1016/j.pathol.2016.11.006. Epub 2017 Jan 5.
Although immunohistochemical detection of the Ki67 antigen has been used for many years to assess cancer proliferation, this marker is still not recommended for routine use in clinical management of breast cancer. The major reason for this situation is a lack of a standardised procedure for Ki67 assessment as well as persistence of several issues of debate with regards to the Ki67 assay interpretation and the marker's clinical utility. Nowadays Ki67 assessment is principally used for estimation of prognosis and guiding the decision on adjuvant treatment choice, as well as for prediction of response to neoadjuvant treatment in ER+/HER2- breast cancer. In ER-/HER2+ and ER-/HER2- tumours, high post-neoadjuvant Ki67 index is associated with unfavourable prognosis. We review here the elements impacting analytical validity of the Ki67 immunohistochemical assay, the evidence of its clinical utility and the current recommendations for its use in breast cancer management.
尽管多年来一直使用Ki67抗原的免疫组化检测来评估癌症增殖，但该标志物仍不建议在乳腺癌的临床管理中常规使用。出现这种情况的主要原因是缺乏Ki67评估的标准化程序，以及在Ki67检测结果解读和该标志物的临床应用方面存在几个仍有争议的问题。如今，Ki67评估主要用于估计预后、指导辅助治疗选择的决策，以及预测ER+/HER2-乳腺癌对新辅助治疗的反应。在ER-/HER2+和ER-/HER2-肿瘤中，新辅助治疗后Ki67指数高与不良预后相关。我们在此回顾影响Ki67免疫组化检测分析有效性的因素、其临床应用的证据以及目前在乳腺癌管理中使用该检测的建议。
