The Effect Of Ki67 Index On The Prognosis Of Patients Receiving And Not Receiving Neoadjuvant Therapy For Breast Cancer

Objective: to analyze the expression of Ki67 in breast cancer patients and its relationship with clinicopathological variables.At the same time,for patients who did not receive neoadjuvant chemotherapy and patients who received neoadjuvant chemotherapy,we analyzed the prognostic impact and predictive value of different Ki67 cutoff values.The optimal cut-off value was determined to provide reference for clinical diagnosis and treatment.Methods: the expression of Ki67 in breast cancer and its relationship with clinicopathological variables were analyzed by using ualcan database.Kaplan Meier plotter database was used to analyze the relationship between Ki67 expression and prognosis of breast cancer patients.The protein-protein interaction network was constructed by string database.Methods: the clinical data of 585 breast cancer patients who did not receive neoadjuvant chemotherapy and 354 breast cancer patients who received neoadjuvant chemotherapy were retrospectively analyzed.Subgroup analysis was performed by different molecular types.Results: the expression of Ki67 in breast cancer was significantly higher than that in adjacent tissues(P<0.01).At the same time,the expression of Ki67 was the highest in21-40 years old patients(P<0.01).The expression of Ki67 in male breast cancer patients was higher than that in female breast cancer patients(P<0.01).The expression of Ki67 was the highest in patients with stage 4 breast cancer(P<0.01).In different molecular types,Ki67 expression was the highest in triple negative breast cancer patients(P<0.01).The expression of Ki67 was the highest in perimenopausal breast cancer patients.Among the patients with different lymph node metastasis,the expression of Ki67 was the highest in N2 patients.At the same time,Kaplan Meier plotter database found that Ki67 high expression was closely related to shorter DFS and OS in breast cancer patients.The protein interaction network of Ki67 was constructed by using string database.It was found that NIFK,TOP2 A,CENPF,DLGAP5 and other proteins were most likely to interact with Ki67.Retrospective analysis of the data of breast cancer patients who did not receive neoadjuvant therapy found that,except for the patients with HER2 overexpression,when the cut-off value of Ki67 was 20%,it had a clear adverse effect on the prognosis of patients and a certain predictive value.For other subtypes,the cutoff value of Ki67 was 14% or 20%,which had no significant impact on the prognosis of patients.For breast cancer patients receiving neoadjuvant therapy,Ki67 cutoff value of14% or 20% has a clear adverse effect on prognosis,and has a good predictive ability.Especially 20% is better.Analysis of different molecular subtypes showed that except HER2 overexpression,Ki67 cut-off value of 20% could predict the prognosis of other molecular subtypes.Conclusion: Bioinformatics analysis showed that the expression of Ki67 in breast cancer was higher than that in adjacent breast cancer.The high expression of Ki67 is positively correlated with the poor prognosis of breast cancer patients.For breast cancer patients without NAC treatment,whether the cutoff value of Ki67 is 14% or 20%,the effect of Ki67 index on prognosis and prediction of breast cancer patients are very limited.For breast cancer patients receiving NAC treatment,the cutoff value of Ki67 is 14% or 20%,which can be found to have adverse prognostic impact and predictive value on breast cancer patients.When the cut-off value is 20%,the prediction is more accurate.For breast cancer patients receiving NAC treatment,the cutoff value of Ki67 is recommended to be 20%.