Meta-Analysis of Prognostic Role of Ki-67 Labeling Index in Gastric Carcinoma

Pyo, Jung‐Soo; Kim, Nae Yu

doi:10.5301/ijbm.5000277

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Although high Ki-67 expression was observed in 75% of patients with positive lymph node metastasis, the present study showed no statistically significant association between Ki-67 expression and lymph node metastasis (P = 1.00). This was in accordance with Pyo and Kim, (22) who reported similar results.…”

Section: Discussionsupporting

confidence: 93%

Prognostic utility of Ki-67 in gastric carcinoma

et al. 2021

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Introduction: Gastric carcinoma represents the third leading cause of cancer related mortality worldwide. Most of cases are diagnosed at the time of tumor metastasis. There is a discrepancy in the results regarding the role of Ki-67 proliferation index as a prognostic factor in gastric carcinoma. Objectives: To assess the prognostic value of Ki-67 proliferation index and correlate Ki-67 expression with the overall survival (OS) in patients with gastric carcinoma. Patients and Methods: This retrospective study included fifty cases collected randomly from archival paraffin blocks of gastric carcinoma. Cases were collected during the period from 2013 to 2018. Sections were prepared and the slides were immunohistochemically stained with Ki-67 antibody. Results: This study showed a statistically significant correlation between higher percentage of Ki-67 expression and cases with tumors located in the fundus and body of the stomach and with distant metastasis. Also a statistically significant correlation between higher mean of Ki-67 positive cell % and cases of adenocarcinoma with pT1 tumors and with loco-regional recurrence (P < 0.001, P=0.02). A higher percentage of Ki-67 expression was found in cases of adenocarcinoma grade III and cases with positive perineural invasion compared to other cases, yet the correlation was statistically insignificant. According to survival analysis, OS rate was 34.0% and the median OS time was 14.6 months. There was no statistically significant association between Ki-67 proliferation index and disease free survival (DFS) and OS. Conclusion: Ki-67 proliferation index can be used as a predictor for distant metastasis and loco-regional recurrence of gastric cancer.

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Section: Discussionsupporting

confidence: 93%

Prognostic utility of Ki-67 in gastric carcinoma

et al. 2021

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“…Our study suggested the cutoff of Ki-67 LI as 25% for DFS. A recent meta-analysis study by Pyo and Kim [26] also shows that Ki-67 LI ≤25% was correlated with worse survival in gastric cancer. However, the optimal cutoff value is still unclear in this field.…”

Section: Discussionmentioning

confidence: 98%

Ki-67 labeling index as a prognostic marker in advanced stomach cancer

Seo

Kim

et al. 2019

Ann Surg Treat Res

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PurposeProliferation marker Ki-67 is widely used in cancer prognosis prediction. We tried to investigate the role of Ki-67 as a prognostic factor in stomach cancer after surgery in this study.MethodsWe retrospectively evaluated 251 patients who underwent curative resection for gastric cancer from 2010 to 2015. In pathologic examination, Ki-67 labeling index was defined as the percentage of Ki-67 antigen positive cells. Prognostic significance of Ki-67 for gastric cancer was evaluated. Disease-free survival (DFS) was assessed as a primary end-point.ResultsThe median follow-up period was 28.0 months. Thirty-one patients (12.4%) showed Ki-67 labeling index (LI) lower than 25%. Sixty-eight patients (26.6%) showed recurrence during follow-up period. Recurrence was associated with Ki-67 LI level (≤25%, P = 0.016), and lymph node metastasis status (P = 0.002). High Ki-67 LI level (>25%) was also related to p53 positivity (P < 0.001) and poorly cohesive type (P = 0.002). The 3-year DFS was 69.4%. Low Ki-67 LI level (≤25%) was related with low DFS (47.6% vs. 72.6%, P = 0.016). T stage (P < 0.001), N stage (P = 0.006), lymphovascular invasion (P = 0.010), and neuronal invasion (P = 0.001) also affected the DFS. In addition, T stage (P = 0.03) and Ki-67 LI (P = 0.035) were independent prognostic factors for DFS. In patients treated with adjuvant chemotherapy (n = 239, 93.4%), low Ki-67 (≤25%) was a poor prognostic factor for DFS (P = 0.013).ConclusionLow Ki-67 LI predicts high rate of progression and low DFS of stomach cancer. Ki-67 LI can be a predictive marker in resected stomach cancer treated with surgery and adjuvant chemotherapy.

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“…These factors are important because they are associated with a variety of critical clinical measures such as malignant potential and therapeutic strategies. Ki-67 quantification, performed using immunohistochemical (IHC) staining, is used as a proliferative marker [1–6]; however, immunohistochemistry (IHC) is expensive and has limited availability in resource-constrained regions. Quantification of proliferative activity by mitotic figures also plays a vital role in predicting tumor proliferation and is often quantitated via hematoxylin and eosin (HE) staining.…”

Section: Introductionmentioning

confidence: 99%

Validation of mitotic cell quantification via microscopy and multiple whole-slide scanners

et al. 2019

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Background The establishment of whole-slide imaging (WSI) as a medical diagnostic device allows that pathologists may evaluate mitotic activity with this new technology. Furthermore, the image digitalization provides an opportunity to develop algorithms for automatic quantifications, ideally leading to improved reproducibility as compared to the naked eye examination by pathologists. In order to implement them effectively, accuracy of mitotic figure detection using WSI should be investigated. In this study, we aimed to measure pathologist performance in detecting mitotic figures (MFs) using multiple platforms (multiple scanners) and compare the results with those obtained using a brightfield microscope. Methods Four slides of canine oral melanoma were prepared and digitized using 4 WSI scanners. In these slides, 40 regions of interest (ROIs) were demarcated, and five observers identified the MFs using different viewing modes: microscopy and WSI. We evaluated the inter- and intra-observer agreements between modes with Cohen’s Kappa and determined “true” MFs with a consensus panel. We then assessed the accuracy (agreement with truth) using the average of sensitivity and specificity. Results In the 40 ROIs, 155 candidate MFs were detected by five pathologists; 74 of them were determined to be true MFs. Inter- and intra-observer agreement was mostly “substantial” or greater (Kappa = 0.594–0.939). Accuracy was between 0.632 and 0.843 across all readers and modes. After averaging over readers for each modality, we found that mitosis detection accuracy for 3 of the 4 WSI scanners was significantly less than that of the microscope ( p = 0.002, 0.012, and 0.001). Conclusions This study is the first to compare WSIs and microscopy in detecting MFs at the level of individual cells. Our results suggest that WSI can be used for mitotic cell detection and offers similar reproducibility to the microscope, with slightly less accuracy.

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Meta-Analysis of Prognostic Role of Ki-67 Labeling Index in Gastric Carcinoma

Cited by 8 publications

References 30 publications

Prognostic utility of Ki-67 in gastric carcinoma

Prognostic utility of Ki-67 in gastric carcinoma

Ki-67 labeling index as a prognostic marker in advanced stomach cancer

Validation of mitotic cell quantification via microscopy and multiple whole-slide scanners

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