Changes in Ki-67 Labeling Indices During Neoadjuvant Chemotherapy for Advanced Ovarian Cancer Are Associated With Survival

作者：Poelcher Martin; Friedrichs Nicolaus; Rudlowski Christian; Fimmers Rolf; Keyver Paik Mignon Denise; Kuebler Kirsten; Sauerwald Axel; Buettner Reinhard; Kuhn Walther; Braun Michael

来源：International Journal of Gynecological Cancer, 2010, 20(4): 555-560.

DOI：10.1111/IGC.0b013e3181c104c0

• Ovarian cancer
• Neoadjuvant chemotherapy
• Ki-67
• Prognostic factors

Objective: To evaluate changes in Ki-67 expression during neoadjuvant chemotherapy (NACT) in advanced ovarian cancer.
Materials and Methods: Patients with International Federation of Gynecology and Obstetrics stage IIIC or IV and large-volume ascites were treated with NACT within a phase 2 trial. The expression of Ki-67 was evaluated by immunohistochemistry on paraffin-embedded tissue samples and classified by percentage of stained cells. Survival curves were plotted using the Kaplan-Meier method.
Results: Comparison of 40 individual paired results from pretreatment and posttreatment samples revealed a median difference of -0.11 in the Ki-67 index (95% confidence interval, -0.20 to -0.01; P = 0.005, signed rank test). Univariate analysis identified a high Ki-67 index as well as an increasing Ki-67 index after NACT as significant prognostic markers for progression-free survival (P = 0.004 and P = 0.001; log-rank test). Six of 12 patients with an increased Ki-67 index after NACT developed recurrence within 6 months after therapy.
Conclusions: Changes of the Ki-67 index during NACT are associated with progression-free survival. If confirmed in prospective trials, an increasing Ki-67 index during pre-operative treatment may serve as an indicator for resistance to chemotherapy.

• 出版日期2010-5
• 单位河北医科大学