Ki-67 expression in breast carcinoma: Its association with grading systems, clinical parameters, and other prognostic factors - A surrogate marker?

Helen Trihia, Susan Murray, Karen Price, Richard D. Gelber, Rastko Golouh, Aron Goldhirsch, Alan S. Coates, John Collins, Monica Castiglione-Gertsch, Barry A. Gusterson

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. The number of mitoses and, thus, the proliferative capacity of a tumor is one of the most crucial variables for tumor grading. The Ki-67 nuclear antigen may be considered as an alternative to mitotic counts in grading schemes and as a single parameter that can be used in fine-needle aspirates and small biopsies. METHODS. Immunohistochemistry using the anti-Ki-67 antibody MIB-1 was performed on 434 breast carcinoma specimens from the International Breast Cancer Study Group (formerly Ludwig) Trial V. Three groups based on Ki-67 percent were used to replace the mitotic counts component in the Nottingham grade (NHG) to produce the Nottingham/Ki-67 grade (NKG) and to assess Ki-67 as a single parameter. RESULTS. In both the lymph node positive subgroup and the lymph node negative subgroup, the NKG and Ki-67 group was correlated significantly with Bloom-Richardson grade (BRG), NHG, and Nottingham type. Tumor size in the lymph node negative cohort and estrogen receptor status, progesterone receptor status, and c-erbB-2 expression in the lymph node positive cohort also were correlated significantly with NKG. Ki-67 percentage was correlated significantly with c-erbB-2 expression in the lymph node positive cohort only. NKG was similar to BRG and NHG when it was evaluated for prognostic significance. Patients with higher categoric Ki-67 percentages had worse overall and disease free survival in all groups except for the untreated, lymph node negative group. CONCLUSIONS. Ki-67 detection represents a valuable tool and is a good objective substitute for mitotic counts when used in a grading system. When it is used alone, Ki-67 detection provides valuable information, although it is necessary to combine this with other parameters in the study of core biopsies and fine-needle aspirates.

Original languageEnglish
Pages (from-to)1321-1331
Number of pages11
JournalCancer
Volume97
Issue number5
DOIs
Publication statusPublished - Mar 1 2003

Keywords

  • Bloom-Richardson grade
  • Breast carcinoma
  • Histologic grade
  • Ki-67, MIB-1
  • Nottingham grade

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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