Östrojen-Progesteron Reseptörü Pozitif ve Aksiller Lenf Nodu Negatif Meme Kanseri Tanılı Hastalarda Ki-67 Proliferasyon İndeksi

Abstract

Amaç: Ki-67 hücre siklusunda G0 fazı dışında eksprese edilen nükleer bir proteindir. Prolifere olan hücreleri gösteren belirteç olarak kullanılmaktadır. Meme kanseri tanılı hastalarda Ki-67 proliferasyon indeksinin kötü klinik sonuçlarla ilişkili olduğu gösterilmiştir. Bu çalışmada östrojen reseptörü ve progesteron reseptörü pozitif, HER-2 negatif, aksiller lenf nodu tutulumu bulunmayan meme kanseri tanılı hastalarda Ki-67 proliferasyon indeksinin prognostik öneminin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: 2006-2014 yılları arasında tanı konulan ve tıbbi onkoloji kliniğinde izlemi bulunan opere meme kanseri tanılı hastalar çalışmaya dahil edildi. İmmunohistokimyasal olarak nükleer Ki-67 proliferasyon indeksi değerlendirildi. Diğer klinikopatolojik prognostik faktörlerle ilişkisi değerlendirildi.

Bulgular: 162 hasta çalışmaya dahil edildi. Medyan 85 (9-132) aylık izlemde 2 (%1.2) hastada lokal nüks, 7 (%4.3) hastada uzak metastaz saptandı. Sekiz (%4.9) hasta vefat etti. Ki-67 proliferasyon indeksine göre Roc curve analizinde elde edilen %20 değerine göre hastalar iki gruba ayırıldı. Ki-67 proliferasyon indeksi %20’nin altında ve üzerinde olan gruplarda 7 yıllık genel sağkalımlar sırasıyla %97.1 ve %90.9 olarak hesaplandı (p0.042). Ki-67 proliferasyon indeksinin tümör histolojik derecesi, patolojik tümör boyutu ile pozitif korelasyon, hormon reseptörleri ile negatif korelasyon gösterdiği saptandı.

Sonuç: Proliferasyon meme kanserinde prognoz ve tedavi yanıtını predikte etmek için kullanılan önemli bir göstergedir. Ki-67 proliferasyon indeksi için standart eşik değeri bulunmaması, değerlendirme ve skorlama metodolojisinde standart olmamasına rağmen diğer klinikopatolojik prognostik göstergelerle birlikte prognoz belirlenmesinde kullanılmaktadır.

Keywords

• Meme kanseri,Ki-67 proliferasyon indeksi,prognoz

Ki-67 Labeling Index in Patients with Estrogen-Progesterone Positive and Axillary Lymph Node Negative Breast Cancer

Abstract

Objective: Ki67 is a nuclear protein that is expressed in all phases of the cell cycle except for G0. It is used as a marker to detect the proliferating cells. It has been shown that Ki-67 labeling index is associated with poor clinical outcome in patients with breast cancer. In this study, we aimed to evaluate the prognostic significance of Ki-67 labeling index in patients with estrogen receptor and progesterone receptor positive, HER-2 negative and axillary lymph node negative breast cancer.

Methods: Patients diagnosed with breast cancer during 2006-2014, and who were followed up in the medical oncology clinic were included in the study. Immunohistochemically, nuclear Ki-67 proliferation index was evaluated. The relationship with other clinicopathologic prognostic factors was evaluated.

Results: 162 patients were included in the study. In a median 85 (9-132)-months follow-up, local recurrence was detected in 2(1.2%) patients and distant metastasis was detected in 7(4.3%) patients. Eight (4.9%) patients died. Patients were divided into two groups using 20% cut-off value for Ki-67 labelling index, obtained by Roc curve analysis. The 7-year overall survival was 97.1% in the group with Ki-67 labeling index below 20%, while it was 90.9% in the group above the 20% value (p=0.042). Ki-67 labeling index showed positive correlation with tumor histological grade, and pathologic tumor size, and negative correlation with hormone receptors.

Conclusion: Proliferation is an important indicator for predicting prognosis and treatment response in breast cancer. Ki-67 labeling index is used to determine prognosis along with other clinicopathological prognostic factors, although there is no standard cut-off value and no standard of assessment and no standard in scoring methodology.

Keywords

• Breast cancer,Ki-67 labeling index,prognosis

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