■评估Ki67在晚期上皮性卵巢癌(EOC)新辅助化疗(NACT)中的表达和预后价值。
■95例晚期EOC患者接受NACT,然后进行间隔减积手术(IDS),可从匹配的治疗前后标本中获取组织样本。通过免疫组织化学评估Ki-67的表达,并按染色细胞的百分比进行分类。通过接受者工作特性分析评估Ki67的最佳截止值。Kaplan-Meier分析,对数秩测试,并采用Cox回归分析进行生存分析。
■通过单因素(HR:1.8,95%CI:1.1-3.0,P值:0.023)和多因素(HR:1.88,95%CI:1.08-3.26,P值:0.025)分析,NACT后Ki67是复发的独立预后因素。残余疾病>1cm(HR:2.69,95%CI:1.31-5.54,P值:0.0070)和治疗前CA125≥1432U/mL(HR:2.00,95%CI:1.13-3.55,P值:0.017)也是多因素分析无进展生存期(PFS)的独立危险因素。NACT后Ki67≥20%是PFS的独立危险因素,然而,基线Ki67和Ki67变化不提示预后意义.在高CA125患者中,高postKi67患者的中位PFS(中位PFS:15.0个月,95%CI:13.4-16.6个月)显着(P值:0.013)与低Ki67患者相比(中位PFS:30.0个月,95%CI:13.5-46.5个月)。
■NACT后Ki67≥20%是接受NACT后接受IDS的晚期EOC患者PFS较差的独立因素。NACT后Ki67和治疗前CA125的组合可以更好地识别NACT给药患者中PFS较差的患者。
UNASSIGNED: To evaluate Ki67 expression and prognostic value during neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer (EOC).
UNASSIGNED: 95 patients with advanced EOC receiving NACT followed by interval debulking surgery (IDS) were available for tissue samples from matched pre- and post-therapy specimens. The expression of Ki-67 was evaluated by immunohistochemistry and classified by percentage of stained cells. The optimal cutoff values of the Ki67 were assessed by receiver operating characteristic analysis. Kaplan-Meier analysis, the Log rank test, and Cox regression analysis were carried out to analyze survival.
UNASSIGNED: Post-NACT Ki67 was an independent prognostic factor for recurrence by univariate (HR: 1.8, 95% CI: 1.1-3.0, P-value: 0.023) and multivariate (HR: 1.88, 95% CI: 1.08-3.26, P-value: 0.025) analysis. Residual disease >1cm (HR: 2.69, 95% CI: 1.31-5.54, P-value: 0.0070) and pre-treatment CA125 ≥ 1432 U/mL (HR: 2.00, 95% CI: 1.13-3.55, P-value: 0.017) were also independent risk factors for progression-free survival (PFS) in multivariate analysis. Post-NACT Ki67 ≥ 20% was an independent risk factor for PFS, however, baseline Ki67 and Ki67 change did not suggest prognostic significance. In patients with high CA125, the median PFS for patients with high postKi67 (median PFS: 15.0 months, 95% CI: 13.4-16.6 months) was significantly (P-value: 0.013) poorer compared to patients with low postKi67 (median PFS: 30.0 months, 95% CI: 13.5-46.5 months).
UNASSIGNED: Post-NACT Ki67 ≥ 20% was an independent factor associated with poorer PFS in patients with advanced-stage EOC undergoing NACT followed by IDS. The combination of post-NACT Ki67 and pretreatment CA125 could better identify patients with poorer PFS in NACT-administered patients.