| Title |
Prognostic value of different cut-off levels of Ki-67 in breast cancer: a systematic review and meta-analysis of 64,196 patients
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, September 2015
|
| DOI | 10.1007/s10549-015-3559-0 |
| Pubmed ID | |
| Authors |
Fausto Petrelli, G. Viale, M. Cabiddu, S. Barni |
| Abstract |
A proliferative marker, expressed as the percentage of cells in a cell cycle, has been developed and used as a discriminant of more aggressive malignant phenotypes in early breast cancer (BC). The marker is usually expressed by the immunohistochemical staining of the cell cycle antigen Ki-67. It has not, however, yet been definitely evaluated, due to methodological concerns, which specific Ki-67 cut-off provide the strongest prognostic information in resected BC. We conducted a meta-analysis to explore the prognostic value of different cut-off levels of Ki-67 in terms of overall survival (OS) and disease-free survival (DFS) in early BC. The databases of PubMed, the ISI Web of Science, EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, and CINHAL were used to identify the relevant literature. Data from studies reporting a hazard ratio (HR) and a 95 % confidence interval (CI) calculated as a multivariate analysis were pooled in a meta-analysis, with metaregression used to test for trends in predefined subgroups. All the statistical tests were 2-sided. Forty-one studies encompassing 64,196 BC patients were included in the analysis. Overall, n = 25 studies were available for the OS analysis. The pooled HR for high versus low Ki-67 was 1.57 (95 % CI 1.33-1.87, P < 0.00001). Twenty-nine studies were available for the DFS analysis. The pooled HR for high versus low Ki-67 was 1.50 (95 % CI 1.34-1.69, P < 0.00001). When a cut-off of Ki-67 staining ≥ 25 % was used, the pooled HR for OS was 2.05 (95 % CI 1.66-2.53, P < 0.00001), which was significantly different to studies where the cut-offs chosen were <25 %. In ER+ tumors, the HR for high versus low Ki-67 was similar and significant (HR = 1.51, 95 % CI 1.25-1.81, P < 0.0001). We conclude that Ki-67 has an independent prognostic value in terms of OS in BC patients. The Ki-67 threshold with the greatest prognostic significance is as yet unknown, but a cut-off >25 % is associated with a greater risk of death compared with lower expression rates. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Chile | 1 | <1% |
| Brazil | 1 | <1% |
| Unknown | 197 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 27 | 14% |
| Student > Ph. D. Student | 26 | 13% |
| Researcher | 23 | 12% |
| Student > Bachelor | 23 | 12% |
| Other | 19 | 10% |
| Other | 38 | 19% |
| Unknown | 43 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 92 | 46% |
| Biochemistry, Genetics and Molecular Biology | 23 | 12% |
| Agricultural and Biological Sciences | 11 | 6% |
| Nursing and Health Professions | 5 | 3% |
| Immunology and Microbiology | 4 | 2% |
| Other | 12 | 6% |
| Unknown | 52 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 89. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 July 2020.
All research outputs
#401,180
of 22,826,360 outputs
Outputs from Breast Cancer Research and Treatment
#36
of 4,659 outputs
Outputs of similar age
#5,646
of 267,016 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#1
of 96 outputs
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