Ki67Expression In Triple Negative Breast Cancer And HER-2Overexpression Breast Cancer And Its Relationship With Prognosis

Objective: Triple-negative breast cancer (TNBC) is a malignantneoplasm characterized by absent expression of estrogen receptor,progesterone receptor and human epidermal growth factor receptor type2(HER-2) receptors. With estrogen-negative, progesterone-negative and HER-2receptors-positive, the overexpression of HER-2is an independent prognosticfactor of poor outcome in patients with breast cancer. The overexpression ofHER-2is same to TNBC with high rate of recurrence and metastasis and poorprognosis. The nuclear-associated antigen Ki67protein may be detected in theactive phases of the cell cycle in late G1, S, G2and M phases, but not in theresting phase. Ki67is closely allied to the proliferation of variety of malignantcells and the ability of invasion and metastasis. This paper mainly discussesthe clinical significance of the expression of ki67and the correlation betweenexpression of ki67in breast cancer of TNBC and the overexpression ofHER-2.Methods: Selected127cases of breast cancer (including87cases ofTNBC and40cases of the overexpression of HER-2) paraffin-embededsamples for experimental specimens from the Fengfeng Group Hospital,January2005to December2008, Ki67counts of127cases of breast cancerwas detected by immunohistochemical staining. Collected the data of clinicalpathology and follow-up, analyzed the relationship between ki67and clinicalpathologic factors by using statistical methods. The patients were groupedaccording to the expression levels of various indicators and the survivalanalysis of breast cancer patients were done by using Kaplan-Mier method(log-rank test) and cox regression models (univariate and multivariateanalysis), and summarize the main factors impacted on survival. Result:1The Clinical pathologic feature of TNBC and the overexpression ofHER-2in breast cancerThere are no statistical difference (P＞0.05) among ages, menopausalstate, histological grading and tumor diameter. Compared with TNBC, theoverexpression of HER-2in breast cancer has high level lymph nodemetastasis rate (P＜0.05), in statistically.2The correlation between the expression of ki67in TNBC and theoverexpression of HER-2in breast cancer with clinicopathological factorsCount ki67expression of different clinical pathological condition inbreast cancer tissue show: The expression of ki67in the group of TNBCwas higher than that of HER-2,with no significantly difference (χ2=1.074, P＞0.05). Differently from tumor diameter and lymph node metastasis, theexpression of ki67was no significantly difference (P＞0.05) among ages,menopausal state and histological grading in the group of TNBC. As for theoverexpression of HER-2in breast cancer, the expression of ki67in the groupof lymph node metastasis in breast cancer was significantly higher than thatwithout lymph node metastasis (P＜0.05). It was show that there is correlationbetween the expression of ki67gene and lymph node metastasis. Theexpression of ki67gene plays an important role in the process of invasion andmetastasis of breast cancer.3Univariate analysis of prognostic in triple negative breast cancerAs positive patients was47.73%, the5-year survival rates in lymph nodenegative patients75.51%; There were significant differences in the statisticalanalysis of both (χ2=9.498, P=0.002); The same as lymph node metastasis, theki67-negative and positive group,5-year survival rate were55.22%and85.0%,respectively (χ2=10.033, P=0.002). The5-year survival rate of tumor diametermore than2cm was50%, less than2cm79.31%, and it demonstrated that therewas direct correlation between tumor size and TNBC in the5-year survivalrate (χ2=10.765, P=0.001). But the5-year survival rate among age,menopausal state and histological grading impact on the prognosis of survival wad not statistically significant (P＞0.05). This suggested that the5-yearsurvival rate of TNBC with lymph node metastasis is low, with tumordiameter bigger and ki67-positive samely.4Univariate analysis of prognostic in the overexpression of HER-2The5-year survival rate of the overexpression of HER-2in the group oflymph node metastasis was significantly lower than that without lymph nodemetastasis (χ2=4.422, P=0.035). The same to lymph node metastasis, there waslower survival rate in the group of positive expression of ki67(χ2=4.235,P=0.04). There ware no statistical difference among ages, tumor diameter,histological grading and menopausal status (P＞0.05). This indicated that the5-year survival rate of HER-2with lymph node metastasis is low, withki67-posive samely.5Cox multivariate analysis of prognosticThe influential factors on the prognosis of survival rate as follows:lymph node metastasis, the expression of ki67. The risk factors affectingoverall survival of lymph node metastasis in the overexpression of HER-2andTNBC (B=10.063, B=6.973, respectively), the expression of ki67(B=3.882,B=4.318, respectively).Conclusion:1As for the TNBC, ki67positive expression was significantly higher inthe group of lymph node metastasis and tumor length, Ki67was positivelycorrelated with lymph node metastasis in the overexpression of HER-2.2Univariate analysis of prognosis showed thatThe level of ki67positive expression and lymph node metastasis had asignificant effect on the prognosis of5-year survival in the overexpression ofHER-2and TNBC, and tumor size played an important role in TNBC.3Cox multivariate analysis of prognostic showed thatThe influential risk factors for survival were lymph node metastasis andthe expression of ki67. Lymph node metastasis was the highest risk factors forthe prognosis of among TNBC and the overexpression of HER-2.