Assessment of Response to Hormonal Therapy by Serum Ki-67 as a Biomarker in Non-metastatic Hormone Positive Breast Cancer: A Prospective Study | ||||
| SECI Oncology Journal | ||||
| Volume 12, Issue 2, April 2024, Page 147-155 | ||||
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| Abstract | ||||
| Background: Breast cancer has the highest incidence among all female patients with different cancer types. It is a lethal disease which threaten women's health. There are many prognostic and predictive factors that implicated in breast cancer. The expression of Ki-67 is strongly associated with cancer proliferation and is a known indicator of breast cancer prognosis and outcome. Ki-67 expression levels are also useful to inform treatment decision making in some cases. As a result, measurement of Ki-67 is routinely done during pathological tumor evaluation. Methods: This study is a prospective study; included eighty-eight of newly diagnosed patients presented to the Outpatient Clinic in South Egypt Cancer Institute, Assiut University with primary breast carcinoma all of them hormonal positive regardless Her2 status. From (1/2022 to 12/2023) before starting hormonal treatment and after 6 months of starting treatment. The study was approved by the Institutional Review Board of the SECI, Assiut University (approval No: 582). An informed written consent was taken from all cases. Serum concentration of Ki-67 was measured using a commercially available Ki- 67 ELISA Kit and tissue expression of Ki-67 was assessed by immunohistochemical technique. Results: In this study, clinical significance of serum Ki-67 as a prognostic indicator in breast cancer was evaluated among eighty-eight hormone- positive early breast cancer cases. More than half of them (56) cases are luminal A breast cancer and (32) cases of them are luminal B, no Her2 enriched breast cancer or triple negative, more than half of them (55%) received Tamoxifen and (45%) received Femara, (31) cases of them are stage I, (37) cases are stage II and (20) cases are stage III, more than half of cases showed lower expression of Ki 67, Higher expression for ki67 (≥20%) detected in 32 cases. Moreover, the relationship between serum Ki-67 by ELISA with clinical, pathologic characteristics and patient outcome were detected. Our study showed that the median (range) value of serum Ki-67 was 0.70 (0.01 – 2.54) ng/ml. serum Ki-67 showed higher median values with increasing age, postmenopausal status, increasing tumor size, nodal affection, higher grade, estrogen and progesterone receptors positive tumors but of no statistical significance. In our study, higher serum Ki-67 level was more frequently associated with HER2-positive and it is statistically significant (p value 0.036). Our study demonstrated that the median time to progression was 10 months. According to Kaplan-Meier analysis, the DFS rate at 20 months was 82.6%. Regarding Overall survival: OS was calculated from date of diagnosis till time of death from any cause. The median OS couldn’t be reached at the end of study, no deaths so 1-year OS is 100%. Conclusion: The results of our study support the finding that serum Ki-67 may be considered a valuable biomarker and add a prognostic information to classical prognostic factors | ||||
| Keywords | ||||
| Breast cancer; Serum ki-67; Prognosis | ||||
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