The Analysis Between Prognosis And Expression Of Ki-67 With Different Clinicopathologic Features Of Infiltrating Ductal Breast Cancer

ObjectiveDisorderly appreciation is the common feature of malignant cells, and it is closely related to the extent of the malignancy status of cancer. The correlation between Ki-67, cell proliferation associated antigen, and the malignant degree of tumor had been reported, but few reports were about the expression of Ki-67 and prognosis.The purpose of this study was based on clinicopathologic data of infiltrating ductal breast cancer to analyse the relationship between prognosis and expression of Ki-67 with different clinicopathologic features of infiltrating ductal breast cancer.MethodsRetrospectivly analysed the breast invasive ductal carcinoma of 583 cases, to analysis of the relationship between the expression of Ki-67 and other clinicopathological features; to explore the relationship of prognosis between Ki-67 expression with different tumor size, lymph node metastasis, ER state, Her-2 state,VEGF state, p53 state, pathological stage and molecular type and the invasive ductal carcinoma.Results1、 Ki-67 expression negative group(<14%) is 97 cases, accounting for 16.64%,and Ki-67 expression positive group(≥14%) total with 486 cases, accounting for83.36%. The average expression level of Ki-67 expression is 37.14±23.81% and the median expression of Ki-67 index is 30%(0%, 90%). There is positive correlation between Ki-67 expression and tumor size(rs=0.107, P=0.011),histopathological grade(rs=0.288, P<0.001), Her-2 expression(rs=0.204,P<0.001), VEGF expression(rs=0.085, P=0.041) and p53 expression(rs=0.292,P<0.001). The correlation between Ki-67 expression and ER expression(rs=-0.352, P<0.001), PR expression(rs=-0.325, P<0.001) was negative.There is no correlation between pathologic stage(rs=0.076, P=0.072), lymphnode metastasis(rs=0.069, P=0.097) and the Ki-67 expression.2、 Disease free survival in univariate analysis results showed: the expression of Ki-67 were prognostic factors of invasive ductal carcinoma in patients with DFS and OS(P=0.001, P=0.018). Multivariate survival analysis showed: Ki-67 expression is the independent prognostic factors of invasive ductal carcinoma in patients with DFS(P= 0.008), but is not independent prognostic factors of invasive ductal carcinoma in patients with OS(P= 0.063).3、 Univariate survival analysis showed that the expression of Ki-67 with Her-2positive type(Luminal B type and Her-2 over expression type) and triple negative breast infiltrating ductal carcinoma has no significant influence on the DFS and OS of patients; but the expression of Ki-67 with Luminal A type infiltrating ductal carcinoma have significant influence on the DFS and OS of patients(P= 0.002, P= 0.017). The expression of Ki-67 with stage I and II had no significant influence on the DFS and OS of patients. The expression of Ki-67 with stage III have significant influence on the DFS and OS of patients(P= 0.012,P= 0.043). The expression of Ki-67 with lymph node negative breast infiltrating ductal carcinoma had no significant influence on DFS and OS of patientsr, but the expression of Ki-67 with lymph node positive was significantly influence on patients with DFS and OS(P= 0.002, P=0.020). Infiltrating ductal carcinoma of breast tumor with less than or equal to 2cm, the Ki-67 expression had no significant effect on the DFS and OS of patients, but with the tumor is greater than 2cm, the Ki-67 expression had a significant influence on the patients with DFS(P=0.007), but had no significant influence on patients with OS. The expression of Ki-67 with ER negative breast had no significant effect on the expression of DFS and OS of patients, but the expression of Ki-67 with ER positive breast cancer was significantly influence DFS and OS of patients(P=0.001, P=0.002). The expression of Ki-67 with Her-2 negative expression had significant effect on DFS and OS of patients(P<0.001, P=0.005), but Ki-67 expression with the Her-2 positive breast cancer had no significant effect on the DFS and OS of patients. The expression of Ki-67 with P53 negative expression had a significant effect on the DFS of patients(P = 0.022), but had no significanteffect on OS. The expression of Ki-67 with P53 positive expression had no significant effect on the DFS and OS of patients. The expression of Ki-67 with VEGF negative expression had a significant effect on patients with DFS and OS of patients(P = 0.005, P = 0.048), but had no significant effect on patients with OS. The expression of Ki-67 with VEGF positive expression had no significant effect on the DFS and OS of patients.Conclusions1、Ki-67 is highly expressed in breast cancer. There is positive correlation between tumor size, histological grade, Her-2 expression, P53 expression, VEGF expression and Ki-67 expression. The correlation between ER expression, PR expression and Ki-67 expression is negative. There is no correlation between the age, menopausal status, lymph node metastasis, histological grade and Ki-67 expression.2、Univariate survival analysis showed that Ki-67 is the influence factors of patients with disease-free survival and overall survival, multivariate survival analysis showed that Ki-67 was an independent prognostic factor influencing disease free survival, but it is not the independent prognostic factors of overall survival.3、 Univariate survival analysis showed that the Ki-67 expression of infiltrating ductal carcinoma of breast with Luminal A, pathology in Study III, positive lymph node, tumor more than 2cm,ER positive, Her-2 negative, P53 negative and VEGF negative expression has a significant impact on the survival of patients. The Ki-67 expression of infiltrating ductal carcinoma of breast with the positive Her-2 type(Luminal B type and Her-2 over expression type), triple negative type, phase I, phase II, tumor less than or equal to 2cm, ER negative, Her-2 positive, p53 positive and VEGF positive expression had no significant effect on the survival of patients. Ki-67 has more predictive value for recurrence and metastasis of patients with moderate and low-grade malignant advanced breast invasive ductal carcinoma, and the higher Ki-67 expression, the worse the prognosis of patients.