The prognostic value of Ki67 in ovarian high-grade serous carcinoma: an 11-year cohort study of Chinese patients
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Ming Chen1, Shuzhong Yao1, Qinghua Cao2, Meng Xia1, Junxiu Liu1 and Mian He1
1Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
2Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Mian He, email: firstname.lastname@example.org
Keywords: high-grade serous ovarian cancer, Ki67, platinum-resistance, survival, prognostic biomarker
Received: August 04, 2016 Accepted: October 19, 2016 Published: December 23, 2016
Objective: This study sought to assess the prognostic role of Ki67 in primary ovarian high-grade serous carcinoma (HGSC) and to determine whether Ki67 expression can predict responsiveness to platinum and paclitaxel chemotherapy.
Results: A total of 318 women were included in the analysis and the median follow-up time was 48 months (range, 3–150 months). Ki67 proliferation indices ranged from 3% to 95% with a median of 40%. Using 40% as the cut-off value for the Ki67 index, we classified 141 patients as having low Ki67 expression and 177 patients as having high Ki67 expression. Low Ki67 expression was a predictor of platinum resistance (hazard ratio (HR) 2.85, 95% CI 1.43–5.98, P < 0.001). In the Kaplan-Meier analysis, comparisons of patients with low versus high Ki67 expression demonstrated that low Ki67 expression was significantly associated with decreased progression-free survival (PFS) (22% vs. 34% for 5-year PFS, P < 0.001) and decreased overall survival (OS) (31% vs. 55%, P < 0.001). Multivariate analysis indicated that low Ki67 expression was associated with decreased PFS (HR 2.98, 95% CI 1.75–6.56, P < 0.001) and decreased OS (HR 1.74, 95% CI 1.38–5.01, P = 0.003).
Materials and Methods: A retrospective study of patients with stage I-IV primary ovarian HGSC was conducted from January 1, 2002, to December 31, 2012. Ki67 levels were measured via immunohistochemistry (IHC) and analyzed with respect to clinicopathological factors, and a survival analysis was performed.
Conclusions: HGSC appears to be a heterogeneous disease with different clinical outcomes. Low Ki67 expression (< 40%) in HGSC is significantly associated with platinum resistance and decreased survival.
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