The proliferation marker Ki67, but not neuroendocrine expression, is an independent factor in the prediction of prognosis of primary prostate cancer patients Cover

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The proliferation marker Ki67, but not neuroendocrine expression, is an independent factor in the prediction of prognosis of primary prostate cancer patients

Radiology and Oncology

Volume 50 (2016): Issue 3 (September 2016)

By: Mariarosa Pascale, Cinzia Aversa, Renzo Barbazza, Barbara Marongiu, Salvatore Siracusano, Flavio Stoffel, Sando Sulfaro, Enrico Roggero, Serena Bonin and Giorgio Stanta

Free to read

|Jul 2016

Figures & Tables

Determination of Ki67, NSE, CgA, SYP in primary prostate cancer patients. Number of concurrent biomarkers evaluated. The number of patients is reported above each column.

Distribution of Ki67 staining score. Positive Ki67 cells in TURP and prostatectomy specimens from a cohort of 166 primary prostate cancer patients.

Representative immunohistochemical staining for Ki67. (A) prostate adenocarcinoma with Ki67 > 10% 20 x and 40 x (B) magnification; (C) prostate adenocarcinoma with Ki67 ≤ 10% 20 x and 40 x (D) magnification; (E) prostate adenocarcinoma negative for Ki67 20 x and 40 x (F) magnification.

Survival curves by NSE staining in patients with primary prostate cancer. p-value from log-rank test is reported. Numbers of at risk (still alive) patients are indicated below the x-axis.

Survival curves by Ki67 expression in patients with primary prostate cancer. (A) Ki67 staining dichotomized in ≤; 10% and > 10%; (B) Ki67 staining divided into negative, 1–10%, 11%–20%, > 20%. p-value from log-rank test is reported. Numbers of at risk (still alive) patients are indicated below the x-axis.

Univariate analysis of prognostic factors in patients with primary prostate cancer based on Cox proportional hazards regression model

Variable	UNIVARIATE
Variable	HR (95% CI)	P-value
Nuclear grading
2 vs 1	1.45 (0.90-2.34)	0.125
3 vs 1	3.49 (1.94-6.27)	< 0.001 Significant value
Gleason score
≥ 7 vs < 7	2.97 (2.07-4.26)	< 0.001 Significant value
Ki67 expression
> 10% vs ≤ 10%	2.75 (1.85-4.09)	< 0.001 Significant value
Age at diagnosis (continuous)	1.04 (1.02-1.07)	< 0.001 Significant value
NSE expression
Positive Only diffuse expression was considered as positive staining; vs negative	1.99 (1.19-3.34)	0.009 Significant value
CgA expression
Positive Only diffuse expression was considered as positive staining; vs negative	0.96 (0.62-1.47)	0.840
Syp expression
Positive Only diffuse expression was considered as positive staining; vs negative	1.18 (0.77-1.81)	0.447
Type of intervention
Prostatectomy vs TURP	0.45 (0.30-0.67)	< 0.001 Significant value

Association between Ki67 expression and clinicopathological variables (N = 146)

Variable	Ki67 expression
Variable	≤ 10%	> 10%	Tot	P-value
Nuclear grading
1	22	1	23
2	72	23	95	0.001 Significant value
3	14	14	28
Gleason Score
< 7	56	8	64	0.001 Significant value
≥ 7	51	30	81
missing 1
Age at diagnosis (median, years)
≤ 71	53	19	72	0.922
> 71	55	19	74
Age at diagnosis (continuous)	108	38	146	0.973
NSE expression
Negative	21	4	25	0.073
Positive Only diffuse expression was considered as positive staining;	28	16	44
missing 77
CgA expression
Negative	37	10	47	0.217
Positive Only diffuse expression was considered as positive staining;	24	12	36
missing 40
Syp expression
Negative	31	8	39	0.326
Positive Only diffuse expression was considered as positive staining;	33	14	47
missing 60
Type of intervention
TURP	78	33	111	0.081
Prostatectomy	29	5	34
missing 1
Total	108	38	146

Neuroendocrine marker staining in our cohort of primary prostate cancer patients

Staining	Neuroendocrine markers
Staining	NSE	CgA	Syp
Negative	28 (31.5)	49 (40.5)	44 (34.6)
Diffuse	50 (56.1)	45 (37.2)	54 (42.5)
Focal	3 (3.4)	19 (15.7)	17 (13.4)
Spotty	8 (9)	8 (6.6)	12 (9.5)
Total	89	121	127
*missing*	77	45	39

Multivariate analysis of prognostic factors in patients with primary prostate cancer based on Cox proportional hazards regression model stratified by type of intervention (N = 144)

Variable	MULTIVARIATE
Variable	Adjusted HR (95%CI)	Adjusted P-value
Nuclear grading
2 vs 1	1.27 (0.75-2.13)	0.373
3 vs 1	1.93 (1.01-3.68)	0.045 Significant value
Gleason score
≥ 7 vs < 7	2.41 (1.56-3.74)	< 0.001 Significant value
Ki67 expression
> 10% vs ≤ 10%	2.14 (1.41-3.25)	< 0.001 Significant value
Age at diagnosis (continuous)	1.04 (1.02-1.07)	0.001 Significant value

Distribution of Ki67 positively stained cells in our cohort of primary prostate cancer patients

% Ki67-positive cells	Number of samples
% Ki67-positive cells	N	%
0	14	9.6
≤ 5	70	47.9
> 5 and ≤ 10	24	16.5
> 10 and ≤ 20	18	12.3
> 20 and ≤ 30	13	8.9
> 30	7	4.8
Total	146	100%

DOI: https://doi.org/10.1515/raon-2016-0033 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 313 - 320

Submitted on: Feb 8, 2016

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Accepted on: Apr 28, 2016

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Published on: Jul 19, 2016

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

primary prostate cancer,

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2016 Mariarosa Pascale, Cinzia Aversa, Renzo Barbazza, Barbara Marongiu, Salvatore Siracusano, Flavio Stoffel, Sando Sulfaro, Enrico Roggero, Serena Bonin, Giorgio Stanta, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons License.

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