Jiang Peng, Jia Mingzhu, Hu Jing, Huang Zhen, Deng Ying, Lai Li, Ding Shanshan, Hu Zhuoying
Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Onco Targets Ther. 2020 Oct 27;13:10841-10850. doi: 10.2147/OTT.S274420. eCollection 2020.
The purpose of this study was to find a cut-off value of the immunohistochemical parameter Ki67 for stage I-II endometrial cancer.
The clinicopathological data of 318 patients with stages I-II endometrial cancer who received primary surgical treatment were retrospectively analyzed. A cut-off value of Ki67 for predicting recurrence of endometrial cancer was determined by using the receiver operating characteristic curve and the Youden index. The Cox regression was performed to screen factors associated with recurrence of endometrial cancer. Based on the cut-off value of Ki67, the patients were divided into two groups, and the differences of clinicopathological parameters between the two groups were compared.
The receiver operating characteristic curve showed that the optimal cut-off value of Ki67 for predicting recurrence of patients with stages I-II endometrial cancer was 38%. The multivariate Cox regression analysis demonstrated that the histotypes (=0.012), myometrial invasion (=0.014), cervical stromal invasion (=0.001), Ki67 (=0.002), estrogen receptor (ER) (=0.045) and P53 (=0.032) were significant prognostic predictors for recurrence of endometrial cancer. The recurrence-free survival and the disease-specific survival of patients in the high-Ki67 group (Ki67 ≥38%) were much lower than those in the low-Ki67 group (Ki67 <38%) (=0.000, =0.001, respectively). Among the 118 patients with early low-risk endometrial cancer who did not receive adjuvant treatment after surgery, the recurrence-free survival of patients in the high-Ki67 group was also lower than those in the low-Ki67 group (=0.000).
The Ki67 was demonstrated to be a useful prognostic factor in patients with stages I-II endometrial cancer, and the Ki67 labeling index 38.0% was optimal cut-off value for predicting recurrence.
本研究旨在寻找I-II期子宫内膜癌免疫组化参数Ki67的临界值。
回顾性分析318例接受初次手术治疗的I-II期子宫内膜癌患者的临床病理资料。采用受试者工作特征曲线和尤登指数确定预测子宫内膜癌复发的Ki67临界值。进行Cox回归分析以筛选与子宫内膜癌复发相关的因素。根据Ki67临界值将患者分为两组，比较两组临床病理参数的差异。
受试者工作特征曲线显示，预测I-II期子宫内膜癌患者复发的Ki67最佳临界值为38%。多因素Cox回归分析表明，组织学类型（=0.012）、肌层浸润（=0.014）、宫颈间质浸润（=0.001）、Ki67（=0.002）、雌激素受体（ER）（=0.045）和P53（=0.032）是子宫内膜癌复发的重要预后预测指标。高Ki67组（Ki67≥38%）患者的无复发生存率和疾病特异性生存率远低于低Ki67组（Ki67<38%）（分别为=0.000，=0.001）。在118例术后未接受辅助治疗的早期低危子宫内膜癌患者中，高Ki67组患者的无复发生存率也低于低Ki67组（=0.000）。
Ki67被证明是I-II期子宫内膜癌患者有用的预后因素，Ki67标记指数38.
