The Value Of Ki-67 In The Prognosis Of Patients With Adenocarcinoma Undergoing Laparoscopic Radical Gastrectomy

Objective:To preliminarily explore the relationship between Ki-67 and the basic information and pathological findings of patients with newly treated resectable gastric cancer,and to analyze the impact of Ki-67 on the prognosis,which could supplement the TNM staging system of gastric cancer,and further stratify the patients and guide the treatment.Methods:90 patients diagnosed with gastric cancer in hospital were selected.Ki-67 index was determined by immunohistochemistry.Survival analysis was used to study the relationship between Ki-67 、 the basic information 、 pathological findings and 5-year overall survival rate of patients.ROC was used to evaluate the ability of the two models which predict the survival of patients.Outcome:Ki-67 index in the low-differentiated gastric cancer group was strikingly lower than that in the patients with medium-high differentiated gastric cancer(P=0.008).The 5-year overall survival rate of patients with low differentiation,T3/T4 stage,N+ stage,and pathological stage II/III was noteworthy lower than that of patients with middle-high differentiation,T1/T2 stage,N0 stage,and stage I(P=0.012,0.013,0.008,and 0.006).It should be noted that the 5-year overall survival rate of patients with Ki-67 index less than 30% was prominently(P=0.003)lower than that of patients with Ki-67 index more than 30%.Multivariate Cox survival analysis showed that pathological stage and Ki-67 proliferation index were independent risk factors for patients’ 5-year overall survival rate(HR=5.114,P=0.026;HR=2.746,P=0.010).Ki-67 combined with pathological staging and differentiation degree model(AUC=0.778)was significantly better than the other two models(AUC=0.636,0.716)in predicting the death of patients.Conclusion:Ki-67 index can be used to evaluate the prognosis of patients with gastric adenocarcinoma undergoing laparoscopic radical gastrectomy.Low index indicates poor prognosis,and Ki-67 combined with pathological stage and degree of differentiation has a good predictive power for the survival of patients.