Comparison of Different Molecular Subtypes with 14% Ki-67 Cut-off Threshold in Breast Cancer Patients of Pakistan- An Indication of Poor Prognosis
Autor: | Tanwir Khaliq, Aisha Akbar, Mehreen Mushtaq, Nazia Khan, Ashok Kumar Tanwani, Asma Khattak, Ahmareen Khalid Sheikh, Muhammad Faraz Arshad Malik, Summaya Sohail Chaudry, Syeda Kiran Riaz |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Receptor ErbB-2 Estrogen receptor Breast Neoplasms Disease Gastroenterology Breast cancer Internal medicine Progesterone receptor medicine Biomarkers Tumor Humans Proliferation Marker Pakistan Pathological biology business.industry General Medicine medicine.disease Prognosis Ki-67 Antigen Ki-67 biology.protein Female business Receptors Progesterone Immunostaining |
Zdroj: | Archives of Iranian medicine. 24(11) |
ISSN: | 1735-3947 |
Popis: | Background: Ki-67 is a proliferation marker that is used not only to categorize patients in luminal A and B subtypes of breast cancers, but also to determine the aggressiveness of the disease in triple negative and human epidermal growth factor 2 (HER2) over expressed molecular subtypes. The present study was designed to evaluate the role of Ki-67 with cut off value of 14% in molecular subgroups and its association with patient prognosis. Methods: Immunostaining was performed on histopathologically confirmed sections (n = 278) to assess expression of Ki-67, estrogen receptor (ER), progesterone receptor (PR) and HER2. Immunoreactivity of molecules was recorded as percentage scoring. Results: Adopting a cut off value of 14%, Ki-67 was high in 88%of the cases included in the study. High Ki-67 was significantly associated with pathological parameters including histological grade, advanced stage and nodal/distant metastasis. Immunoexpression of ER, PR and HER2 also showed strong correlation with high expression of Ki-67. Based on the St. Gallen classification, the cases were categorized into luminal A (10%) and luminal B (51%), triple negative (20%) and HER2 enriched (18%). Ki-67 index was also significantly high in 98% of HER2 enriched and 95% of TNBC patients. Interestingly, Ki-67 score with cut off value of 14% proved to be significant in deciphering prognosis in luminal patients. Moreover, high expression of Ki-67 also proved to be a marker of poor prognosis, especially in triple negative patients. Conclusion: We suggest that utilization of IHC4 status i.e. ER, PR, HER2 and Ki-67 along with pathological findings and molecular subtyping can considerably affect clinical as well as therapeutic decisions. |
Databáze: | OpenAIRE |
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