Araştırma Makalesi
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Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy

Yıl 2023, Cilt: 33 Sayı: 3, 65 - 70, 04.10.2023
https://doi.org/10.26650/Tr-ENT.2023.1272209

Öz

Objective: The prognostic importance of Ki-67 expression in early-stage glottic larynx cancer is controversial. In this study, we aimed to evaluate the prognostic importance of Ki-67 expression in early-stage glottic cancer treated with curative radiotherapy at a single centre.

Material and Method: Between 2010 and 2021, patients with T1a/bN0 stage glottic larynx cancer treated with curative radiotherapy were identified. The cases included in this study were re-evaluated by a single pathologist retrospectively. According to the ROC curve, the optimal cut-off value was 35% for Ki-67. Above these cut-off points were accepted as high expression levels (Ki-67-high), while below these points were accepted as low expression levels (Ki-67-low).

Results: A total of 49 patients with early-stage glottic larynx cancer treated with definitive radiotherapy were included. The median follow-up time was 35.74 (range; 7.03-161.65) months. The median OS was 95.4 (range; 62.1-128.8) months. According to univariate analysis, tumour grade (p=0.006) and Ki-67 expression level (low vs high; p=0.039) were the prognostic factors that predict OS. The median DFS was 42.1 (range; 32.8-51.3) months. According to univariate analyses, tumour grade (p=0.008) and Ki-67 expression level (low vs high; p=0.007) were the prognostic factors that predict DFS.

Conclusion: Higher Ki-67 expression was associated with lower OS and DFS. Ki-67 expression level can be used as a biomarker to determine treatment choice in these patients. Additional prospective studies with more patients are needed to confirm our results.

Destekleyen Kurum

none

Kaynakça

  • Williamson AJ, Bondje S. Glottic Cancer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 18, 2022. google scholar
  • Cenik Z, Uyar Y, Ozer B, Bulun E. Surgical Treatment in Larynx Cancer. Selcuk Tıp Dergisi 1994;10(2):151-6. google scholar
  • Mucha-Małecka A, Chrostowska A, Urbanek K, Małecki K. Prognostic factors in patients with T1 glottic cancer treated with radiotherapy. Strahlenther Onkol 2019;195(9):792-804. google scholar
  • Pakkanen P, Irjala H, Ilmarinen T, Halme E, Lindholm P, Mäkitie A, et al. Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy. Int J Radiat Oncol Biol Phys 2022;113(1):96-100. google scholar
  • Kanyılmaz G, Yavuz BB, Aktan M, Karaağaç M, Uyar M, Fındık S. Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors. Eur J Breast Health 2019;15(4):256-61. google scholar
  • Dumitru CS, Ceausu AR, Comsa S, Raica M. Loss of E-Cadherin Expression Correlates With Ki-67 in Head and Neck Squamous Cell Carcinoma. In Vivo 2022;36(3):1150-54. google scholar
  • Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 2017;67(2):93-9. google scholar
  • College of American Pathologist. Available from: URL: http://www. cap. org. (Accessed 2022 September 24). google scholar
  • Kop E, de Bock GH, Noordhuis MG, Slagter-Menkema L, van der Laan BFAM, Langendijk JA, et al. Standardised Ki-67 proliferation index assessment in early-stage laryngeal squamous cell carcinoma in relation to local control and survival after primary radiotherapy. Clin Otolaryngol 2020;45(1):12-20. google scholar
  • Cavaliere M, Bisogno A, Scarpa A, D’Urso A, Marra P, Colacurcio V, et al. Biomarkers of laryngeal squamous cell carcinoma: a review. Ann Diagn Pathol 2021;54:151787. google scholar
  • Gioacchini FM, Alicandri-Ciufelli M, Magliulo G, Rubini C, Presutti L, Re M. The clinical relevance of Ki-67 expression in laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2015;272(7):1569-76. google scholar
  • Kropveld A, Slootweg PJ, Blankenstein MA, Terhaard CH, Hordijk GJ. Ki-67 and p53 in T2 laryngeal cancer. Laryngoscope 1998;108(10):1548-52. google scholar
  • Ahmed WA, Suzuki K, Imaeda Y, Horibe Y. Ki-67, p53 and epidermal growth factor receptor expression in early glottic cancer involving the anterior commissure treated with radiotherapy. Auris Nasus Larynx 2008;35(2):213-19. google scholar
  • Sakata K, Oouchi A, Nagakura H, Akiba H, Tamakawa M, Koito K, et al. Accelerated radiotherapy for T1, 2 glottic carcinoma: analysis of results with KI-67 index. Int J Radiat Oncol Biol Phys 2000;47(1):81-8. google scholar
  • Nichols AC, Whelan F, Basmaji J, Dhaliwal S, Dowthwaite S, Chapeskie C, et al. Ki-67 expression predicts radiotherapy failure in early glottic cancer. J Otolaryngol Head Neck Surg 2012;41(2):124-30. google scholar
  • Lavertu P, Adelstein DJ, Myles J, Secic M. P53 and Ki-67 as outcome predictors for advanced squamous cell cancers of the head and neck treated with chemoradiotherapy. Laryngoscope 2001;111(11):1878-92. google scholar
  • Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am. 2008;41(4):757-vii. google scholar

Küratif Radyoterapi ile Tedavi Edilmiş Erken Evre Glottik Larinks Kanserinde Ki-67'nin Prognostik Önemi

Yıl 2023, Cilt: 33 Sayı: 3, 65 - 70, 04.10.2023
https://doi.org/10.26650/Tr-ENT.2023.1272209

Öz

Amaç: Erken evre glottik larinks kanserinde Ki-67 ekspresyonunun prognostik önemi halen tartışmalıdır. Bu çalışmada küratif radyoterapi ile tedavi edilmiş erken evre glottik larinks kanserde Ki-67 ekspresyonunun prognostik önemini değerlendirmek amaçlanmıştır.
Metod: 2010-2021 yılları arasında kliniğimizde küratif radyoterapi ile tedavi edilmiş T1a/bN0 hastalar tespit edildikten sonra olgular geriye dönük olarak tek bir patolog tarafından Ki-67 ekspresyonu açısından yeniden değerlendirilmiştir. ROC eğrisine göre Ki-67 için optimal cut-off değeri %35 tespit edilmesi nedeniyle bu eşik noktasının üstü yüksek ekspresyon (Ki-67-yüksek), altı ise düşük ekspresyon (Ki-67-düşük) olarak kabul edilmiştir.
Bulgular: Küratif radyoterapi ile tedavi edilmiş toplam 49 hasta analize dahil edildi. Ortanca takip süresi 35,74 (7,03-161,65) ay idi. Ortanca genel sağkalım süresi (GS) 95,4 (62,1-128,8) ay idi. Tek değişkenli analize göre, tümör gradı (p=0.006) ve Ki-67 ekspresyon düzeyi (p=0.039) GS’yi öngören anlamlı prognostik faktörler olarak saptandı. Ortanca hastalıksız sağkalım süresi (HSS) 42,1 (32,8-51,3) ay idi. Tek değişkenli analizlere göre, tümör gradı (p=0.008) ve Ki-67 ekspresyon düzeyi (p=0.007), HSS’yi öngören anlamlı prognostik faktörler olarak bulundu.
Sonuç: Ki-67 ekspresyonu sağkalımı öngörebilecek prognostik bir belirteç olarak bulunmuş olup yüksek ekspresyon düzeyi daha düşük GS ve HSS ile ilişkilendirilmiştir. Ki-67 ekspresyon seviyesi, bu hastalarda tedavi seçimini belirlemek için bir biyobelirteç olarak kullanılabilir. Sonuçlarımızı doğrulamak için daha fazla hasta ile ek prospektif çalışmalara ihtiyaç vardır.

Kaynakça

  • Williamson AJ, Bondje S. Glottic Cancer. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 18, 2022. google scholar
  • Cenik Z, Uyar Y, Ozer B, Bulun E. Surgical Treatment in Larynx Cancer. Selcuk Tıp Dergisi 1994;10(2):151-6. google scholar
  • Mucha-Małecka A, Chrostowska A, Urbanek K, Małecki K. Prognostic factors in patients with T1 glottic cancer treated with radiotherapy. Strahlenther Onkol 2019;195(9):792-804. google scholar
  • Pakkanen P, Irjala H, Ilmarinen T, Halme E, Lindholm P, Mäkitie A, et al. Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy. Int J Radiat Oncol Biol Phys 2022;113(1):96-100. google scholar
  • Kanyılmaz G, Yavuz BB, Aktan M, Karaağaç M, Uyar M, Fındık S. Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors. Eur J Breast Health 2019;15(4):256-61. google scholar
  • Dumitru CS, Ceausu AR, Comsa S, Raica M. Loss of E-Cadherin Expression Correlates With Ki-67 in Head and Neck Squamous Cell Carcinoma. In Vivo 2022;36(3):1150-54. google scholar
  • Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 2017;67(2):93-9. google scholar
  • College of American Pathologist. Available from: URL: http://www. cap. org. (Accessed 2022 September 24). google scholar
  • Kop E, de Bock GH, Noordhuis MG, Slagter-Menkema L, van der Laan BFAM, Langendijk JA, et al. Standardised Ki-67 proliferation index assessment in early-stage laryngeal squamous cell carcinoma in relation to local control and survival after primary radiotherapy. Clin Otolaryngol 2020;45(1):12-20. google scholar
  • Cavaliere M, Bisogno A, Scarpa A, D’Urso A, Marra P, Colacurcio V, et al. Biomarkers of laryngeal squamous cell carcinoma: a review. Ann Diagn Pathol 2021;54:151787. google scholar
  • Gioacchini FM, Alicandri-Ciufelli M, Magliulo G, Rubini C, Presutti L, Re M. The clinical relevance of Ki-67 expression in laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2015;272(7):1569-76. google scholar
  • Kropveld A, Slootweg PJ, Blankenstein MA, Terhaard CH, Hordijk GJ. Ki-67 and p53 in T2 laryngeal cancer. Laryngoscope 1998;108(10):1548-52. google scholar
  • Ahmed WA, Suzuki K, Imaeda Y, Horibe Y. Ki-67, p53 and epidermal growth factor receptor expression in early glottic cancer involving the anterior commissure treated with radiotherapy. Auris Nasus Larynx 2008;35(2):213-19. google scholar
  • Sakata K, Oouchi A, Nagakura H, Akiba H, Tamakawa M, Koito K, et al. Accelerated radiotherapy for T1, 2 glottic carcinoma: analysis of results with KI-67 index. Int J Radiat Oncol Biol Phys 2000;47(1):81-8. google scholar
  • Nichols AC, Whelan F, Basmaji J, Dhaliwal S, Dowthwaite S, Chapeskie C, et al. Ki-67 expression predicts radiotherapy failure in early glottic cancer. J Otolaryngol Head Neck Surg 2012;41(2):124-30. google scholar
  • Lavertu P, Adelstein DJ, Myles J, Secic M. P53 and Ki-67 as outcome predictors for advanced squamous cell cancers of the head and neck treated with chemoradiotherapy. Laryngoscope 2001;111(11):1878-92. google scholar
  • Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am. 2008;41(4):757-vii. google scholar
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kulak Burun Boğaz
Bölüm Araştırma Makaleleri
Yazarlar

Gül Kanyılmaz 0000-0003-2333-353X

Sıdıka Fındık 0000-0002-3364-7498

Berrin Benli Yavuz 0000-0001-7816-4687

Meryem Aktan 0000-0002-0447-7784

Fakih Cihat Eravcı 0000-0001-9092-7923

Yayımlanma Tarihi 4 Ekim 2023
Gönderilme Tarihi 28 Mart 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 33 Sayı: 3

Kaynak Göster

APA Kanyılmaz, G., Fındık, S., Benli Yavuz, B., Aktan, M., vd. (2023). Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy. The Turkish Journal of Ear Nose and Throat, 33(3), 65-70. https://doi.org/10.26650/Tr-ENT.2023.1272209
AMA Kanyılmaz G, Fındık S, Benli Yavuz B, Aktan M, Eravcı FC. Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy. Tr-ENT. Ekim 2023;33(3):65-70. doi:10.26650/Tr-ENT.2023.1272209
Chicago Kanyılmaz, Gül, Sıdıka Fındık, Berrin Benli Yavuz, Meryem Aktan, ve Fakih Cihat Eravcı. “Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated With Radiotherapy”. The Turkish Journal of Ear Nose and Throat 33, sy. 3 (Ekim 2023): 65-70. https://doi.org/10.26650/Tr-ENT.2023.1272209.
EndNote Kanyılmaz G, Fındık S, Benli Yavuz B, Aktan M, Eravcı FC (01 Ekim 2023) Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy. The Turkish Journal of Ear Nose and Throat 33 3 65–70.
IEEE G. Kanyılmaz, S. Fındık, B. Benli Yavuz, M. Aktan, ve F. C. Eravcı, “Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy”, Tr-ENT, c. 33, sy. 3, ss. 65–70, 2023, doi: 10.26650/Tr-ENT.2023.1272209.
ISNAD Kanyılmaz, Gül vd. “Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated With Radiotherapy”. The Turkish Journal of Ear Nose and Throat 33/3 (Ekim 2023), 65-70. https://doi.org/10.26650/Tr-ENT.2023.1272209.
JAMA Kanyılmaz G, Fındık S, Benli Yavuz B, Aktan M, Eravcı FC. Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy. Tr-ENT. 2023;33:65–70.
MLA Kanyılmaz, Gül vd. “Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated With Radiotherapy”. The Turkish Journal of Ear Nose and Throat, c. 33, sy. 3, 2023, ss. 65-70, doi:10.26650/Tr-ENT.2023.1272209.
Vancouver Kanyılmaz G, Fındık S, Benli Yavuz B, Aktan M, Eravcı FC. Prognostic Importance of Ki-67 Expression in Early-Stage Glottic Larynx Cancer Treated with Radiotherapy. Tr-ENT. 2023;33(3):65-70.