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The prognostic value of Ki67 is dependent on estrogen receptor status and histological grade in premenopausal patients with node-negative breast cancer.

Klintman, Marie LU ; Bendahl, Pär-Ola LU ; Grabau, Dorthe LU ; Lövgren, Kristina LU ; Malmström, Per LU and Fernö, Mårten LU (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)
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Contribution to journal
publication status
published
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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
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af646149-175b-40e0-8611-a6e7d53ad51f (old id 1511609)
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http://www.ncbi.nlm.nih.gov/pubmed/19935641?dopt=Abstract
date added to LUP
2009-12-07 11:11:26
date last changed
2017-01-08 05:28:12
@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 (&lt;/=20 vs &gt;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},
  volume       = {23},
  year         = {2010},
}