Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma
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 progn...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Oxford University Press
2019-10-01
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| Series: | BJS Open |
| Online Access: | https://doi.org/10.1002/bjs5.50175 |
| _version_ | 1818560476950298624 |
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| author | I. Pergolini S. Crippa M. Pagnanelli G. Belfiori A. Pucci S. Partelli C. Rubini P. Castelli G. Zamboni M. Falconi |
| author_facet | I. Pergolini S. Crippa M. Pagnanelli G. Belfiori A. Pucci S. Partelli C. Rubini P. Castelli G. Zamboni M. Falconi |
| author_sort | I. Pergolini |
| collection | DOAJ |
| description | 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 (P = 0·016 and P = 0·002 respectively). Ki‐67 index was an independent predictor of poor DFS (hazard ratio (HR) 0·52, 95 per cent c.i. 0·29 to 0·91; P = 0·022) and DSS (HR 0·53, 0·31 to 0·91; P = 0·022). Moreover, Ki‐67 index correlated strongly with tumour grade (P < 0·001). Patients with PDAC classified as a G3 tumour with a Ki‐67 index above 50 per cent had poor survival outcomes compared with other patients (P < 0·001 for both DFS and DSS). 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. |
| first_indexed | 2024-12-14T00:38:55Z |
| format | Article |
| id | doaj.art-dd8272c323cb4c208e73cc239ffc2549 |
| institution | Directory Open Access Journal |
| issn | 2474-9842 |
| language | English |
| last_indexed | 2024-12-14T00:38:55Z |
| publishDate | 2019-10-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | BJS Open |
| spelling | doaj.art-dd8272c323cb4c208e73cc239ffc25492022-12-21T23:24:28ZengOxford University PressBJS Open2474-98422019-10-013564665510.1002/bjs5.50175Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinomaI. Pergolini0S. Crippa1M. Pagnanelli2G. Belfiori3A. Pucci4S. Partelli5C. Rubini6P. Castelli7G. Zamboni8M. Falconi9Department of Surgery Università Politecnica delle Marche Ospedali Riuniti, Ancona ItalyPancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Università Vita e Salute IRCCS San Raffaele Scientific Institute Milan ItalyPancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Università Vita e Salute IRCCS San Raffaele Scientific Institute Milan ItalyDepartment of Surgery Università Politecnica delle Marche Ospedali Riuniti, Ancona ItalyDepartment of Surgery Università Politecnica delle Marche Ospedali Riuniti, Ancona ItalyPancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Università Vita e Salute IRCCS San Raffaele Scientific Institute Milan ItalyDepartment of Pathology Università Politecnica delle Marche Ospedali Riuniti, Ancona ItalyDepartment of Pathology Ospedale Sacro Cuore – Don Calabria Negrar ItalyDepartment of Pathology Ospedale Sacro Cuore – Don Calabria Negrar ItalyPancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Università Vita e Salute IRCCS San Raffaele Scientific Institute Milan ItalyBackground 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 (P = 0·016 and P = 0·002 respectively). Ki‐67 index was an independent predictor of poor DFS (hazard ratio (HR) 0·52, 95 per cent c.i. 0·29 to 0·91; P = 0·022) and DSS (HR 0·53, 0·31 to 0·91; P = 0·022). Moreover, Ki‐67 index correlated strongly with tumour grade (P < 0·001). Patients with PDAC classified as a G3 tumour with a Ki‐67 index above 50 per cent had poor survival outcomes compared with other patients (P < 0·001 for both DFS and DSS). 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.https://doi.org/10.1002/bjs5.50175 |
| spellingShingle | I. Pergolini S. Crippa M. Pagnanelli G. Belfiori A. Pucci S. Partelli C. Rubini P. Castelli G. Zamboni M. Falconi Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma BJS Open |
| title | Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| title_full | Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| title_fullStr | Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| title_full_unstemmed | Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| title_short | Prognostic impact of Ki‐67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| title_sort | prognostic impact of ki 67 proliferative index in resectable pancreatic ductal adenocarcinoma |
| url | https://doi.org/10.1002/bjs5.50175 |
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