title: Ki-67 expression in primary breast carcinomas and their axillary lymph node metastases: clinical implications.
abstract: Proliferative activity of tumour cells assessed by immunohistochemical Ki-67 expression is one of several prognostic indicators in breast cancer. The major objective of this study was to investigate the prognostic impact of Ki-67 proliferative activity in the axillary lymph node metastases and in the matched primary breast carcinoma from 194 patients. There was a statistically significant up-regulation of Ki-67 protein in the metastatic deposit compared to where the primary tumour was found (p = 0.001). A low Ki-67 index in both the primary and the metastatic tumours was a favorable prognostic factor. A high index in both primary and metastatic lesion and an up-regulation from a low index in the primary tumour to a high index in the metastatic deposit represented an unfavorable prognostic factor. Multivariate analysis showed that Ki-67 expression in the metastases was a superior independent prognostic factor of clinical outcomes compared to that in the primary tumours. Ki-67 expression in > or =10% of carcinoma cells in the primary tumours and > or =15% in the nodal metastases seems to be optimal cut-off levels. Ki-67 is of value as an independent prognostic factor in breast cancer.
authors.affiliation: Department of Pathology, Ullevaal University Hospital, Kirkeveien 166, N-0407 Oslo, Norway. daehoon.park@ulleval.no
authors.forename: Daehoon
authors.initials: D
authors.lastname: Park
authors.forename: Rolf
authors.initials: R
authors.lastname: Kåresen
authors.forename: Tove
authors.initials: T
authors.lastname: Noren
authors.forename: Torill
authors.initials: T
authors.lastname: Sauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis
chemical_list: D019394:Ki-67 Antigen; D011960:Receptors, Estrogen