Ki-67在三阴性乳腺癌中的预后和预测潜力。,Scientific Reports

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Ki-67在三阴性乳腺癌中的预后和预测潜力。
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-14 , DOI: 10.1038/s41598-019-57094-3
Xiuzhi Zhu _{1,

2,

3} , Li Chen _{1,

2,

3} , Binhao Huang _{1,

4} , Yue Wang _{1,

5} , Lei Ji _{1,

3} , Jiong Wu _{1,

2,

3} , Genhong Di _{1,

2,

3} , Guangyu Liu _{1,

2,

3} , Keda Yu _{1,

2,

3} , Zhimin Shao _{1,

2,

3,

6} , Zhonghua Wang _{1,

2,

3}

Affiliation

作为细胞增殖生物标志物，Ki-67主要用于ER + / HER2-乳腺癌。然而，Ki-67在三阴性乳腺癌（TNBC）中的重要性和最佳分界点尚不清楚，并在此研究中进行了评估.2011年至2016年，复旦大学上海癌症中心共有1800例早期浸润性TNBC患者被连续招募参加这项研究。Ki-67的最佳截止值由Cutoff Finder评估。进行倾向得分匹配（PSM，比率= 1：2）以使Ki-67low组与Ki-67high组匹配。使用Kaplan-Meier方法和Cox回归模型比较两组的总生存期（OS）和无病生存期（DFS）。Ki-67与预后最相关的临界值为30％（p = 0.008）。在30％的临界点，Ki-67high组的DFS和OS较差。在多变量分析中，N阶段（p <0.001），T阶段（p = 0.038）和30％阈值（p = 0.020）的Ki-67与OS独立相关。在亚组分析中，当肿瘤大小≤2cm（p = 0.008）或淋巴结阴性（N-）（p = 0.038），尤其是T1N0M0（阶段）时，DFS的30％Ki-67临界值具有预后和预测潜力I）TNBC。对于945例N-TNBC患者，Ki-67high高组（p = 0.017）比Ki-67low低组（p = 0.875）辅助化疗（CT）的OS更好。对于I / Ki-67期低的患者，辅助CT并不影响DFS（p = 0.248）。因此，在TNBC中，Ki-67截止值为30％具有OS和DFS的早期独立预后和预测潜力，而Ki-67> 30％与较差的预后显着相关，特别是对于I期患者。对于I / Ki-67期低TNBC患者，CT的优势尚不清楚，为将来的降级治疗提供了基础。

"点击查看英文标题和摘要"

The prognostic and predictive potential of Ki-67 in triple-negative breast cancer.

As a cell proliferation biomarker, Ki-67 is principally used in ER+/HER2- breast cancer. However, the importance and the best cutoff point of Ki-67 in triple-negative breast cancer (TNBC) remains unclear and was evaluated in this study.A total of 1800 patients with early invasive TNBC between 2011 and 2016 at Fudan University Shanghai Cancer Center were consecutively recruited for this study. The optimal cutoff for Ki-67 was assessed by Cutoff Finder. Propensity score matching (PSM, ratio = 1:2) was performed to match the Ki-67low group with the Ki-67high group. Overall survival (OS) and disease-free survival (DFS) were compared between the two groups using the Kaplan-Meier method and Cox regression model. The most relevant cutoff value for Ki-67 for prognosis was 30% (p = 0.008). At the cutoff point of 30%, worse DFS and OS were observed in the Ki-67high group. In multivariate analyses, N-stage (p < 0.001), T-stage (p = 0.038), and Ki-67 at the 30% threshold (p = 0.020) were independently linked to OS. In subgroup analysis, Ki-67 cutoff at 30% had prognostic and predictive potential for DFS with either tumor size ≤2 cm (p = 0.008) or lymph node-negative (N-) (p = 0.038) and especially with T1N0M0 (stage I) TNBCs. For 945 N- TNBC patients, adjuvant chemotherapy (CT) was associated with better OS in the Ki-67high group (p = 0.017) than in the Ki-67low group (p = 0.875). For stage I/Ki-67low patients, adjuvant CT did not affect DFS (p = 0.248). Thus, Ki-67 cutoff at 30% had early independent prognostic and predictive potential for OS and DFS in TNBCs, and Ki-67 > 30% was significantly associated with worse prognosis, especially for stage I patients. For stage I/Ki-67low TNBC patients, the advantage of CT is unclear, providing the basis for future de-escalation therapy.

更新日期：2020-01-14

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