Prognostic value of Ki67 in localized prostate carcinoma: a multi-institutional study of >1000 prostatectomies

Background: Expanding interest in and use of active surveillance for early state prostate cancer (PC) has increased need for prognostic biomarkers. Using a multi-institutional tissue microarray resource including over 1000 radical prostatectomy samples, we sought to correlate Ki67 expression capture...

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Bibliographic Details
Published in:Prostate cancer and prostatic diseases 2016-09, Vol.19 (3), p.264-270
Main Authors: Tretiakova, M S, Wei, W, Boyer, H D, Newcomb, L F, Hawley, S, Auman, H, Vakar-Lopez, F, McKenney, J K, Fazli, L, Simko, J, Troyer, D A, Hurtado-Coll, A, Thompson, I M, Carroll, P R, Ellis, W J, Gleave, M E, Nelson, P S, Lin, D W, True, L D, Feng, Z, Brooks, J D
Format: Article
Language:English
Subjects:
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Algorithms
Analysis
Automation
Biomarkers
Biomedical and Life Sciences
Biomedicine
Cancer
Cancer Research
Cancer surgery
Cell Proliferation
Continuity (mathematics)
Cores
Gene expression
Genetic aspects
Health hazards
Humans
Image analysis
Image processing
Kaplan-Meier Estimate
Ki-67 Antigen - metabolism
Male
Metastases
Metastasis
Neoplasm Grading
Neoplasm Staging
original-article
Prognosis
Proportional Hazards Models
Prostate
Prostate cancer
Prostate carcinoma
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms - metabolism
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Recurrence
Seminal vesicle
Statistical models
Surgery
Survival
Tissue Array Analysis
Tumors
Urological surgery
Watchful waiting (Medical care)
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Summary:Background: Expanding interest in and use of active surveillance for early state prostate cancer (PC) has increased need for prognostic biomarkers. Using a multi-institutional tissue microarray resource including over 1000 radical prostatectomy samples, we sought to correlate Ki67 expression captured by an automated image analysis system with clinicopathological features and validate its utility as a clinical grade test in predicting cancer-specific outcomes. Methods: After immunostaining, the Ki67 proliferation index (PI) of tumor areas of each core (three cancer cores/case) was analyzed using a nuclear quantification algorithm (Aperio). We assessed whether Ki67 PI was associated with clinicopathological factors and recurrence-free survival (RFS) including biochemical recurrence, metastasis or PC death (7-year median follow-up). Results: In 1004 PCs (∼4000 tissue cores) Ki67 PI showed significantly higher inter-tumor (0.68) than intra-tumor variation (0.39). Ki67 PI was associated with stage ( P
ISSN:1365-7852
1476-5608
DOI:10.1038/pcan.2016.12