Analysis of the relationship between Ki-67 expression and chemotherapy and prognosis in advanced non-small cell lung cancer

Abstract

Background To analyse the relationship between the Ki-67 index of advanced non-small cell lung cancer (NSCLC) and the objective response rate (ORR) and progression-free survival (PFS) of patients who received chemotherapy. Methods The Ki-67 index of advanced NSCLC pathology was established by immunohistochemistry; using univariate and multivariate analyses, we retrospectively analysed the relationship between the Ki-67 index of 112 advanced NSCLC patients in our hospital and chemotherapy response and PFS. Both epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) were found to be wild type in adenocarcinoma patients, and no gene testing was performed for those with squamous cell carcinoma. All selected patients received four cycles of platinum-based chemotherapy, and according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1), the curative effect was evaluated after every two cycles. Results In the univariate and multivariate analyses, the Ki-67 index was significantly associated with the objective response to chemotherapy (B =−0.069, P=0.000). Ki-67 expression could also accurately predict the ORR of chemotherapy [P<0.0001, area under the curve (AUC) =0.7467, 95% confidence interval (CI): 0.6578–0.8356]: squamous cell carcinoma group [P=0.0003, AUC =0.8065 (95% CI: 0.6922–0.9208)], adenocarcinoma group [P=0.0193, AUC =0.6810 (95% CI: 0.5360–0.8262)]. The overexpression of Ki-67 was a negative prognostic factor for PFS in advanced NSCLC (P<0.0001): squamous cell carcinoma (P=0.0055), adenocarcinoma (P<0.0001). According to the multivariate Cox analysis, Ki-67 index (P=0.000) and stage (P=0.001) were negative factors of PFS. Conclusions The Ki-67 index might be a clinically significant biomarker in advanced NSCLC and may be able to predict the efficacy of chemotherapy. High expression of Ki-67 might also be an indicator of shortened PFS time.

Nomogram for the preoperative prediction of Ki-67 expression and prognosis in stage IA lung adenocarcinoma based on clinical and multi-slice spiral computed tomography features

“…Therefore, the results of the present study suggested that segmentectomy should be the preferred surgical procedure for early-stage NSCLC. Some studies have reported that the expression level of Ki-67 and tumor stage affect PFS, which is consistent with the results of this study [ 10 ].…”

“…Furthermore, this method may increase the incidence of pneumothorax by approximately 15% [ 9 ]. High expression of Ki-67 is an unfavorable factor affecting progression-free survival (PFS) [ 10 ]. Therefore, developing a noninvasive method to accurately predict Ki-67 expression in stage IA LUAD preoperatively is highly important.…”

Diagnostic Performance of Radiomics in Prediction of Ki-67 Index Status in Non-small Cell Lung Cancer: A Systematic Review and Meta-Analysis

“…Specifically in lung cancer, cells expressing Ki-67 exhibit heightened proliferation, greater invasiveness, and a higher likelihood of lymph node metastasis (22). Its higher expression might also be an indicator of shortened progression-free survival (PFS) time (23). In addition, it yields prognostic importance in lung adenocarcinoma subtypes, suggests its potential as a marker in lung neuroendocrine tumors, and identifies its clinical significance in advanced NSCLC, particularly in predicting chemotherapy efficacy (23, 24).…”

Aggressive Progression to EGFR Tyrosine Kinase inhibitors in Advanced NSCLC Patients: Concomitant Mutations, Prognostic Indicator and Subsequent Management

“…In terms of predicting e cacy, Ki-67 index might predict the e cacy of chemotherapy. Wang et al 19 reported that the high expression of Ki-67 may also be an indicator of the shortened PFS of chemotherapy. Nevertheless, studies that have used Ki-67 index to predict the e cacy of targeted therapy in advanced NSCLC are rare.…”