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Increase of Ki‐67 index and influence on mortality in patients with neuroendocrine neoplasms
Author(s) -
Holmager Pernille,
Langer Seppo W.,
Federspiel Birgitte,
Willemoe Gro Linno,
Garbyal Rajendra Singh,
Melchior Linea,
Klose Marianne,
Kjaer Andreas,
Hansen Carsten Palnaes,
Andreassen Mikkel,
Knigge Ulrich
Publication year - 2021
Publication title -
journal of neuroendocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.062
H-Index - 116
eISSN - 1365-2826
pISSN - 0953-8194
DOI - 10.1111/jne.13018
Subject(s) - ki 67 , medicine , doubling time , gastroenterology , hazard ratio , proliferation index , neuroendocrine tumors , pathology , confidence interval , immunohistochemistry , cell , biology , genetics
Abstract An increase in the Ki‐67 index in neuroendocrine neoplasms over time in relation to prognosis has scarcely been investigated. We aimed to assess whether the Ki‐67 index changed over time and also whether a change influenced prognosis. Second, we investigated the difference in the Ki‐67 index between primary tumour and metastases. From 1 January 1995 to 31 December 2019, 108 consecutive patients with gastroenteropancreatic tumours were included. Patients were followed with regard to an increase in the Ki‐67 index and all‐cause mortality. Ki‐67 determination of the primary tumour at diagnosis and at the time of radiological progression, including developed metastases, was performed. A significant increase in the Ki‐67 index was defined as a doubling of the value at disease progression compared to the value at diagnosis. In addition, in 14 patients, the Ki‐67 index of the primary tumour and present metastases at the time of diagnosis was investigated. At diagnosis, there were no differences in the Ki‐67 index between primary tumours and metastases ( P = .41). Sixty‐five patients had a doubling of the Ki‐67 index. The median Ki‐67 index at the time of progression 17% (1%‐90%) vs 5% (1%‐60%) at the time of diagnosis ( P = .006). A doubling of the Ki‐67 index was independently associated with all‐cause mortality (hazard ratio = 2.7 [1.3‐6.3], P = 0.02), after adjustment for relevant co‐variables including the Ki‐67 index at baseline. Doubling of the Ki‐67 index at the time of disease progression was associated with a significantly higher risk of all‐cause mortality. We recommend that a Ki‐67 index is obtained whenever disease progression is recorded by demonstrated progression because it may have impact on the choice of treatment.