The prognostic value of Ki67 is dependent on estrogen receptor status and histological grade in premenopausal patients with node-negative breast cancer.
(2010) In Modern Pathology : an official journal of the United States and Canadian Academy of Pathology, Inc 23. p.251-259- Abstract
- The aim of this study was to evaluate the prognostic value of Ki67 in relation to established prognostic factors in lymph node-negative breast cancer, and furthermore, whether the prognostic impact was dependent on estrogen receptor (ER) status and histological grade. In 200 premenopausal patients, with 5 years of follow-up, Ki67 was determined on tissue microarrays. In univariate analysis, Ki67 (</=20 vs >20%) was a prognostic factor for distant disease-free survival (hazard ratio: 2.7, 95% confidence interval: 1.3-5.4, P=0.005) and overall survival (hazard ratio: 4.9, 95% confidence interval: 1.7-14, P=0.003). When stratifying for ER status and histological grade, Ki67 was a significant prognostic factor for distant disease-free... (More)
- The aim of this study was to evaluate the prognostic value of Ki67 in relation to established prognostic factors in lymph node-negative breast cancer, and furthermore, whether the prognostic impact was dependent on estrogen receptor (ER) status and histological grade. In 200 premenopausal patients, with 5 years of follow-up, Ki67 was determined on tissue microarrays. In univariate analysis, Ki67 (</=20 vs >20%) was a prognostic factor for distant disease-free survival (hazard ratio: 2.7, 95% confidence interval: 1.3-5.4, P=0.005) and overall survival (hazard ratio: 4.9, 95% confidence interval: 1.7-14, P=0.003). When stratifying for ER status and histological grade, Ki67 was a significant prognostic factor for distant disease-free survival and overall survival only in the ER-positive group, and only in patients with histological grade 2, respectively. In multivariate analysis, human epidermal growth factor receptor 2 and age were independent prognostic factors for distant disease-free survival, whereas Ki67, histological grade, and tumor size were not. Ki67 was, however, an independent prognostic factor in the 87% of the patients who had not received adjuvant medical treatment. Agreement between the three readers was very good (kappa-values: 0.83-0.88). Furthermore, Ki67 was a significant prognostic factor for all three investigators (hazard ratio: 2.7-3.2). This study shows that Ki67 is a prognostic factor in node-negative breast cancer. It is noteworthy that the prognostic information of Ki67 is restricted to ER-positive patients, and to patients with histological grade 2. Taken together, Ki67, as an easily assessed and reproducible proliferation factor, may be an alternative or complement to histological grade as a prognostic tool and for selection of adjuvant treatment.Modern Pathology advance online publication, 20 November 2009; doi:10.1038/modpathol.2009.167. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1511609
- author
- Klintman, Marie LU ; Bendahl, Pär-Ola LU ; Grabau, Dorthe LU ; Lövgren, Kristina LU ; Malmström, Per LU and Fernö, Mårten LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Modern Pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
- volume
- 23
- pages
- 251 - 259
- publisher
- Nature Publishing Group
- external identifiers
-
- wos:000274233100011
- pmid:19935641
- scopus:76349123384
- ISSN
- 1530-0285
- DOI
- 10.1038/modpathol.2009.167
- language
- English
- LU publication?
- yes
- id
- af646149-175b-40e0-8611-a6e7d53ad51f (old id 1511609)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19935641?dopt=Abstract
- date added to LUP
- 2016-04-04 09:04:36
- date last changed
- 2022-04-08 01:22:18
@article{af646149-175b-40e0-8611-a6e7d53ad51f, abstract = {{The aim of this study was to evaluate the prognostic value of Ki67 in relation to established prognostic factors in lymph node-negative breast cancer, and furthermore, whether the prognostic impact was dependent on estrogen receptor (ER) status and histological grade. In 200 premenopausal patients, with 5 years of follow-up, Ki67 was determined on tissue microarrays. In univariate analysis, Ki67 (</=20 vs >20%) was a prognostic factor for distant disease-free survival (hazard ratio: 2.7, 95% confidence interval: 1.3-5.4, P=0.005) and overall survival (hazard ratio: 4.9, 95% confidence interval: 1.7-14, P=0.003). When stratifying for ER status and histological grade, Ki67 was a significant prognostic factor for distant disease-free survival and overall survival only in the ER-positive group, and only in patients with histological grade 2, respectively. In multivariate analysis, human epidermal growth factor receptor 2 and age were independent prognostic factors for distant disease-free survival, whereas Ki67, histological grade, and tumor size were not. Ki67 was, however, an independent prognostic factor in the 87% of the patients who had not received adjuvant medical treatment. Agreement between the three readers was very good (kappa-values: 0.83-0.88). Furthermore, Ki67 was a significant prognostic factor for all three investigators (hazard ratio: 2.7-3.2). This study shows that Ki67 is a prognostic factor in node-negative breast cancer. It is noteworthy that the prognostic information of Ki67 is restricted to ER-positive patients, and to patients with histological grade 2. Taken together, Ki67, as an easily assessed and reproducible proliferation factor, may be an alternative or complement to histological grade as a prognostic tool and for selection of adjuvant treatment.Modern Pathology advance online publication, 20 November 2009; doi:10.1038/modpathol.2009.167.}}, author = {{Klintman, Marie and Bendahl, Pär-Ola and Grabau, Dorthe and Lövgren, Kristina and Malmström, Per and Fernö, Mårten}}, issn = {{1530-0285}}, language = {{eng}}, pages = {{251--259}}, publisher = {{Nature Publishing Group}}, series = {{Modern Pathology : an official journal of the United States and Canadian Academy of Pathology, Inc}}, title = {{The prognostic value of Ki67 is dependent on estrogen receptor status and histological grade in premenopausal patients with node-negative breast cancer.}}, url = {{http://dx.doi.org/10.1038/modpathol.2009.167}}, doi = {{10.1038/modpathol.2009.167}}, volume = {{23}}, year = {{2010}}, }