Li Shuai, Chen Xiaosong, Shen Kunwei
Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.
Front Surg. 2022 Jun 28;9:905575. doi: 10.3389/fsurg.2022.905575. eCollection 2022.
To investigate the association of Ki-67 change pattern after core needle biopsy (CNB) and prognosis in HR+/HER2- early breast cancer patients.
Eligible patients were categorized into three groups: Low group, Elevation group, and High group. Chi-square test and logistic regression analysis were used to compare the clinic-pathological characteristics. Kaplan-Meier method was used to estimate the rates of recurrence-free interval (RFI) and breast cancer-specific survival (BCSS), which were compared the Log-rank test. Cox proportional hazard analysis was performed to investigate independent prognostic factors.
A total of 2,858 patients were included: 1,179 (41.3%), 482 (16.9%), and 1,197 (41.8%) patients were classified into the low, elevation, and high groups, respectively. Age, tumor size, histological grade, lymph-vascular invasion (LVI), and ER level status were associated with Ki-67 change pattern after CNB. With a median follow-up of 53.6 months, the estimated 5-year RFI rates for the low group, elevation, and high groups were 96.4%, 95.3% and 90.9%, respectively ( < 0.001). And 5-year BCSS rates were 99.3%, 98.3% and 96.8%, respectively ( = 0.001). Compared with patients in the low group, patients in the high group had significantly worse RFI (hazard ratio [] 1.71, 95% confidence interval [] 1.16-2.54) in multivariate analysis.
Ki-67 change after CNB was associated with prognosis in HR+/HER2- early breast cancer. Patients with Ki-67 high or elevation after CNB had an inferior disease outcome, indicating the necessity of re-evaluating Ki-67 on surgical specimens after CNB.
探讨粗针穿刺活检（CNB）后Ki-67变化模式与HR+/HER2-早期乳腺癌患者预后的相关性。
符合条件的患者分为三组：低组、升高组和高组。采用卡方检验和逻辑回归分析比较临床病理特征。采用Kaplan-Meier法估计无复发生存期（RFI）和乳腺癌特异性生存率（BCSS），并通过对数秩检验进行比较。进行Cox比例风险分析以研究独立预后因素。
共纳入2858例患者：分别有1179例（4¹³%）、482例（16.9%）和1197例（41.8%）患者被分为低组、升高组和高组。年龄、肿瘤大小、组织学分级、淋巴管浸润（LVI）和雌激素受体（ER）水平状态与CNB后Ki-67变化模式相关。中位随访53.6个月，低组、升高组和高组的估计5年RFI率分别为96.4%、95.3%和90.9%（P<0.001）。5年BCSS率分别为99.3%、98.3%和96.8%（P=0.001）。多因素分析显示，与低组患者相比，高组患者的RFI明显更差（风险比[HR]1.71，95%置信区间[CI]1.16-2.54）。
CNB后Ki-67变化与HR+/HER2-早期乳腺癌预后相关。CNB后Ki-67高或升高患者的疾病结局较差，提示CNB后对手术标本重新评估Ki-67的必要性。
