Distinctive Prognostic Value Of Ki-67 In Different Genetypes Of NSCLC Patients

Objective : To investigate the association of Ki-67 with clinicopathological characteristics and prognostic value in different genetyes advanced NSCLC patients.Methods:347 cases of unresected local advanced or advanced NCSCL patients were selected from the first affiliated hospital of China Medical University and collected their clinical data and survival information.Genetic test results were achieved from plasma samples or tumor tissue samples by high throughput sequencing and Ki-67 were retrospectively analysed by immunohistochemisty.To further verify the prognostic value of Ki-67,we further peformed a clinical study with the original data in TCGA and 67 cases of NSCLC patients were finally slected as the validation dataset.The relationship between Ki-67 and clinicopathological characteristics(such as gender,age,pathological type,tumor size,lymph node metastasis,TMM stage,ECOG score and different gene status)was examined by Spearman’s rank correlation.Survival curves were calculated by the Kaplan-Meier method.Cox model analyzes single and multiple factors.P<0.05 was considered to indicate a statistically significant difference.Results:Ki-67 was significantly related with gender,pathological type,lymph node metastasis and EGFR gene mutation stage in our dataset and the same as EGFR and KRAS gene mutation stage in the TCGA validate dataset.In the aspect of survival,low Ki-67 proliferation index indicates better survival for PFS and OS in EGFR gene wild type、EGFR gene mutation type、KRAS gene wild type、PIK3CA gene wild type and PTEN gene wild type groups but not for KRAS gene mutation type group.Furthermore,Ki-67 can also play a great predictive factor for therapeutic effect and patients with low Ki-67 proliferation index indicated better effect for chemotherapy and targeted therapy.PIK3 CA gene mutation type(4 samples)and PTEN gene mutation type(4 samples)and were not incorporated into our analysis temporarily because small sample size.However,there was no predictive value of prognosis for Ki-67 in any genetype NSCLC patients based on the TCGA database.Conclusion:Ki-67 is an independent prognostic factor in local advanced or advanced NSCLC patients and a great predictive factor of therapeutic effect for chemotherapy and targeted therapy.