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

• Published in: Cancer 2003-03, Vol.97 (5), p.1321-1331
• Main Authors: TRIHIA, Helen, MURRAY, Susan, PRICE, Karen, GELBER, Richard D, GOLOUH, Rastko, GOLDHIRSCH, Aron, CRATES, Alan S, COLLINS, John, CASTIGLIONE-GERTSCH, Monica, GUSTERSON, Barry A
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Disease-Free Survival; Female; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry; Ki-67 Antigen - metabolism; Mammary gland diseases; Medical sciences; Multivariate Analysis; Prognosis; Randomized Controlled Trials as Topic; Tumors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.11188

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. 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. 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. 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.