Prognostic impact of Ki-67 proliferative index in resectable pancreatic ductal adenocarcinoma.
Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal
/ metabolism
Disease-Free Survival
Female
Humans
Immunohistochemistry
/ methods
Italy
/ epidemiology
Ki-67 Antigen
/ metabolism
Male
Middle Aged
Neoplasm Grading
Pancreatectomy
/ methods
Pancreatic Neoplasms
/ metabolism
Prognosis
Retrospective Studies
Survival Analysis
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
19
01
2019
accepted:
26
03
2019
entrez:
9
10
2019
pubmed:
9
10
2019
medline:
9
10
2019
Statut:
epublish
Résumé
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease characterized by complex biological features and poor prognosis. A prognostic stratification of PDAC would help to improve patient management. The aim of this study was to analyse the expression of Ki-67 in relation to prognosis in a cohort of patients with PDAC who had surgical treatment. Patients who had pancreatic resection between August 2010 and October 2014 for PDAC at two Italian centres were reviewed retrospectively. Patients with metastatic or locally advanced disease, those who received neoadjuvant chemotherapy, patients with PDAC arising from intraductal papillary mucinous neoplasm and those with missing data were excluded. Clinical and pathological data were retrieved and analysed. Ki-67 expression was evaluated using immunohistochemistry and patients were stratified into three subgroups. Survival analyses were performed for disease-free (DFS) and disease-specific (DSS) survival outcomes according to Ki-67 expression and tumour grading. A total of 170 patients met the selection criteria. Ki-67 expression of 10 per cent or less, 11-50 per cent and more than 50 per cent significantly correlated with DFS and DSS outcomes ( Ki-67 index could be of use in predicting the survival of patients with PDAC. Further investigation in larger cohorts is needed to validate these results. El adenocarcinoma ductal de páncreas ( Se efectuó un análisis retrospectivo de pacientes sometidos a resección pancreática por PDAC en dos centros italianos entre agosto de 2010 y octubre de 2014. Se excluyeron los pacientes con enfermedad metastásica o localmente avanzada, los tratados con quimioterapia neoadyuvante, los pacientes con PDAC originado en una neoplasia papilar mucinosa intraductal y aquellos pacientes con datos incompletos. Se analizaron los datos clínicos y anatomopatológicos. La expresión de Ki‐67 se evaluó por inmunohistoquímica y los pacientes se estratificaron en tres grupos. Se calculó la supervivencia libre de enfermedad ( Un total de 170 pacientes cumplió los criterios de selección. La expresión de Ki‐67 del ≤ 10%, 11‐50% y > 50% mostró una correlación significativa con los resultados de DFS y DSS ( El índice Ki‐67 se puede utilizar como predictor de supervivencia en pacientes con PDAC. Hace falta seguir investigando para validar estos resultados en cohortes más grandes.
Sections du résumé
Background
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease characterized by complex biological features and poor prognosis. A prognostic stratification of PDAC would help to improve patient management. The aim of this study was to analyse the expression of Ki-67 in relation to prognosis in a cohort of patients with PDAC who had surgical treatment.
Methods
Patients who had pancreatic resection between August 2010 and October 2014 for PDAC at two Italian centres were reviewed retrospectively. Patients with metastatic or locally advanced disease, those who received neoadjuvant chemotherapy, patients with PDAC arising from intraductal papillary mucinous neoplasm and those with missing data were excluded. Clinical and pathological data were retrieved and analysed. Ki-67 expression was evaluated using immunohistochemistry and patients were stratified into three subgroups. Survival analyses were performed for disease-free (DFS) and disease-specific (DSS) survival outcomes according to Ki-67 expression and tumour grading.
Results
A total of 170 patients met the selection criteria. Ki-67 expression of 10 per cent or less, 11-50 per cent and more than 50 per cent significantly correlated with DFS and DSS outcomes (
Conclusion
Ki-67 index could be of use in predicting the survival of patients with PDAC. Further investigation in larger cohorts is needed to validate these results.
Antecedentes
El adenocarcinoma ductal de páncreas (
Métodos
Se efectuó un análisis retrospectivo de pacientes sometidos a resección pancreática por PDAC en dos centros italianos entre agosto de 2010 y octubre de 2014. Se excluyeron los pacientes con enfermedad metastásica o localmente avanzada, los tratados con quimioterapia neoadyuvante, los pacientes con PDAC originado en una neoplasia papilar mucinosa intraductal y aquellos pacientes con datos incompletos. Se analizaron los datos clínicos y anatomopatológicos. La expresión de Ki‐67 se evaluó por inmunohistoquímica y los pacientes se estratificaron en tres grupos. Se calculó la supervivencia libre de enfermedad (
Resultados
Un total de 170 pacientes cumplió los criterios de selección. La expresión de Ki‐67 del ≤ 10%, 11‐50% y > 50% mostró una correlación significativa con los resultados de DFS y DSS (
Conclusión
El índice Ki‐67 se puede utilizar como predictor de supervivencia en pacientes con PDAC. Hace falta seguir investigando para validar estos resultados en cohortes más grandes.
Autres résumés
Type: Publisher
(spa)
El adenocarcinoma ductal de páncreas (
Identifiants
pubmed: 31592095
doi: 10.1002/bjs5.50175
pii: BJS550175
pmc: PMC6773637
doi:
Substances chimiques
Ki-67 Antigen
0
Types de publication
Journal Article
Langues
eng
Pagination
646-655Informations de copyright
© 2019 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
Références
Ann Surg. 2019 Jun;269(6):1154-1162
pubmed: 31082915
Lancet. 2016 Jul 2;388(10039):73-85
pubmed: 26830752
Neuroendocrinology. 2016;103(2):153-71
pubmed: 26742109
Hepatogastroenterology. 2012 Nov-Dec;59(120):2640-3
pubmed: 22534537
Pancreatology. 2018 Jan;18(1):2-11
pubmed: 29191513
Anticancer Res. 2006 Nov-Dec;26(6C):4873-8
pubmed: 17214354
Clin Cancer Res. 2011 Feb 15;17(4):635-7
pubmed: 21304000
Cancer Cytopathol. 2014 Oct;122(10):770-8
pubmed: 25044931
J Clin Oncol. 2008 Dec 1;26(34):5569-75
pubmed: 18981464
Gastrointest Endosc. 2012 Sep;76(3):570-7
pubmed: 22898415
Ann Surg Treat Res. 2015 Apr;88(4):200-7
pubmed: 25844354
Endoscopy. 2014 Jan;46(1):32-8
pubmed: 24218309
World J Gastroenterol. 2016 Dec 7;22(45):9944-9953
pubmed: 28018101
Nature. 2016 Mar 3;531(7592):47-52
pubmed: 26909576
J Am Coll Surg. 2008 May;206(5):833-46; discussion 846-8
pubmed: 18471707
Cytopathology. 2014 Dec;25(6):389-95
pubmed: 24750272
Am J Surg. 2003 Nov;186(5):486-92
pubmed: 14599612
Cancer Res. 2014 Jun 1;74(11):2913-21
pubmed: 24840647
Br J Cancer. 2007 May 21;96(10):1504-13
pubmed: 17453008
Virchows Arch. 2018 Mar;472(3):341-349
pubmed: 29134440
J Natl Cancer Inst. 2014 Mar;106(3):dju011
pubmed: 24563516
Eur J Cancer. 2012 Jul;48(11):1608-15
pubmed: 22129889
Ann Surg Oncol. 2009 Dec;16(12):3316-22
pubmed: 19707831
Am J Surg Pathol. 2012 Dec;36(12):1743-6
pubmed: 23154766
Am Soc Clin Oncol Educ Book. 2017;37:301-310
pubmed: 28561672
Mod Pathol. 2010 Jun;23(6):824-33
pubmed: 20305616
J Cell Physiol. 2000 Mar;182(3):311-22
pubmed: 10653597
Gastroenterol Res Pract. 2017;2017:9207616
pubmed: 28421110
PLoS Med. 2012;9(5):e1001216
pubmed: 22675273
Histopathology. 2006 May;48(6):674-82
pubmed: 16681683
Int J Surg. 2014 Dec;12(12):1495-9
pubmed: 25046131