Power of PgR expression as a prognostic factor for ER-positive/HER2-negative breast cancer patients at intermediate risk classified by the Ki67 labeling index.
Power of PgR expression as a prognostic factor for ER-positive/HER2-negative breast cancer patients at intermediate risk classified by the Ki67 labeling index.
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DOI：
10.1186/s12885-017-3331-4
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发表时间：
2017-05-22
期刊：
影响因子：
3.8
通讯作者：
Kurosumi M
中科院分区：
文献类型：
--
作者：
Kurozumi S;Matsumoto H;Hayashi Y;Tozuka K;Inoue K;Horiguchi J;Takeyoshi I;Oyama T;Kurosumi M
Ki67标记指数(LI)被认为是ER阳性/HER2阴性乳腺癌患者的重要预后指标。近来，PGR的表达被认为是另一种预后指标。在本研究中，我们探讨了Ki67和PGR在判断乳腺癌预后中的作用和最合适的临界值，并评估了在ER阳性/HER2阴性乳腺癌中Ki67 LI和PGR表达的关系。在本研究中，从2000年到2001年连续177名患有ER阳性/HER2阴性的非特殊类型浸润性癌的日本妇女被纳入研究对象。根据Ki67LI和PGR的表达分析肿瘤的无复发生存期(RFS)和肿瘤特异性生存期(CS)，并评价选择预后不良患者的有意义的临界值。Ki67LI作为预后标记物的临界值与P值比较显示为10%和30%的双峰型。在PgR状态检查的分界点中，20%PgR阳性对预测生存差异最显著(RFS：P=0.0003；Css：P<0.05；P<0.0001)。多因素分析显示PgR(≥20%)是一项独立的预后指标(RFS值：P=0.0092；CSS值：P值=0.00014)。此外，在Ki67LI为10-30%的中危组中，低PGR<；20%组的RFS和CS的预后明显较差(RFS：P<0.0001；CS：P<0.0001)。PgR的表达是评估ER阳性/HER2阴性乳腺癌长期预后的一个有效的预后指标，最合适的临界值为20%。此外，根据Ki67LI的评估，在ER阳性/HER2阴性的中等风险患者中，PGR状态是选择预后较差的患者的有效方法。本文的在线版本(doi：10.1186/s12885-0173331-4)包含补充材料，授权用户可以使用。
The Ki67 labeling index (LI) is regarded as a significant prognostic marker in ER-positive/HER2-negative breast cancer patients. The expression of PgR has recently been identified as another prognostic marker. In the present study, we investigated the prognostic utilities and most suitable cut-off values for Ki67 and PgR, and evaluated the relationship between Ki67 LI and PgR expression in ER-positive/HER2-negative breast cancer. In the present study, 177 consecutive Japanese women with ER-positive/HER2-negative invasive carcinoma of no special type who were treated between 2000 and 2001 were enrolled. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed according to Ki67 LI and PgR expression, and significant cut-off values for selecting patients with a poor prognosis were evaluated. The cut-off values for Ki67 LI as a prognostic marker plotted against P values showed bimodal peaks at 10% and 30%. Among the cut-off points examined for the PgR status, 20% PgR positivity was the most significant for predicting survival differences (RFS: P = 0.0003; CSS: P < 0.0001). A multivariate analysis showed that PgR (≥20%) was an independent prognostic marker (RFS: P = 0.0092; CSS: P = 0.00014). Furthermore, in the intermediate risk group with Ki67 LI of 10–30%, the low PgR <20% group had a markedly poorer prognosis for RFS and CSS (RFS: P < 0.0001; CSS: P < 0.0001). The expression of PgR is a potent prognostic indicator for evaluating the long-term prognosis of ER-positive/HER2-negative breast cancer, and the most suitable cut-off value was found to be 20%. Furthermore, the PgR status is a powerful method for selecting patients with a poor prognosis among ER-positive/HER2-negative patients at intermediate risk, as assessed using Ki67 LI. The online version of this article (doi:10.1186/s12885-017-3331-4) contains supplementary material, which is available to authorized users.