Clinical Significance Of Ki-67 And PR In HER2-negative Luminal Type Breast Cancer And Analysis Of Related Factors Of Recurrence And Metastasis

Objective:To investigate the clinical significance and value of expression of Ki-67 and PR in HER2-negative Luminal type breast cancer.Methods:Retrospective study methods were used to collect the clinical and pathological data and follow-up results of 466 HER2-negative patients with Luminal type breast cancer in the Fourth Hospital of Hebei Medical University.The cutoff values expressed in Ki-67 and PR were 14%and 20%,and the HER2-negative Luminal breast was collected.The cancer was divided into four groups with the following subgroups:Group A(PR high risk group):PR<20%,Ki-67<14%;Group B(Ki-67 high risk group):PR≥20%,Ki-67≥14%Group C(double high risk group):PR<20%,Ki-67≥14%,D(double low risk group):PR≥20%,Ki-67<14%.The differences in clinical pathological features,disease-free survival status,and investigate the influencing factors of DFS in each stage(1 year,2 years,3 years,4 years,5years)of HER2-negative Luminal type breast cancer.The X~2 test was used to compare the clinicopathologic features between groups.Kaplan-Meier method and COX regression were used for survival analysis.Results:1.Four groups had statistical differences in DFS at each stage(2 years,3years,4 years,5 years)(P=0.000;P=0.024;P=0.001;P=0.000);Two-to-two KM survival analysis was performed on DFS at 4 and 5 years of DFS in four groups of patients.The prognosis of group A was worse than that of group B and D.There was statistical difference between each stage(P values were less than 0.05);The prognosis of group C was worse than that of group B and D.The prognosis of group A was worse than that of group B(P=0.025;P=0.034).The prognosis of group A was worse than that of group D(P=0.000;P=0.001).The prognosis of group C was worse than that of group B(P=0.024;P=0.005).The prognosis of the group was worse than that of the D group(P=0.000;P=0.000).There was no significant difference between the A group and the C group(P=0.814;P=0.989).There was no significant difference between the B group and the D group(P=0.060;P=0.098).2.Univariate analysis of DFS at each stage,N-staging,TNM staging,ER,PR,lymph node metastasis level,and family history were statistically significant(each factor P value was less than 0.05).Luminal classification had statistically significant DFS at 3,4 and 5 years(P values??less than 0.05).T-staging(P=0.061)was not a risk factor for 3-year DFS,and surgical approach(P=0.037)was only a risk factor for 5-year DFS.3.Multivariate analysis of DFS at each stage showed that ER(P=0.001;P=0.000;P=0.001;P=0.001)is an independent risk factor,family history(P=0.029;P=0.038)is an independent risk factor for DFS at3 and 4-year.In addition,N stage(P=0.000)and TNM(P=0.002)were independent risk factors affecting 3-year DFS.Conclusions:1.In HER2-negative Luminal breast cancer patients,regardless of the expression level of Ki-67,patients with PR<20%have poorer prognosis than those with PR≥20%.According to further grouping of Ki-67 and PR,the prognosis can be judged,individualized and accurate treatment can be provided to patients.2.Univariate analysis of DFS at each stage,N-staging,TNM staging,ER,PR,lymph node metastasis level,and family history were statistically significant.The Luminal types were statistically significant in DFS at 3and 4years.T is not a risk factor for DFS for 3 years.Surgical methods are risk factors for 5-year DFS.3.COX multivariate analysis showed that ER was an independent risk factor affecting DFS at each stage.Family history was an independent risk factor affecting 3 and 4-year DFS.In addition,N stage was an independent risk factor affecting 3-year DFS.Combined with Ki-67 and PR tests,the prognosis of HER2-negative Luminal patients can be well predicted.