title: Prognostic value of Ki-67 for prostate cancer death in a conservatively managed cohort.
abstract: BACKGROUND
  Standard clinical parameters cannot accurately differentiate indolent from aggressive prostate cancer. Our previous work showed that immunohistochemical (IHC) Ki-67 improved prediction of prostate cancer death in a cohort of conservatively treated clinically localised prostate cancers diagnosed by transurethral resection of the prostate (TURP). Here, we present results in a more clinically relevant needle biopsy cohort.
  
  
  METHODS
  Biopsy specimens were microarrayed. The percentage of Ki-67 positively stained malignant cells per core was measured and the maximum score per individual used in analysis of time to death from prostate cancer using a Cox proportional hazards model.
  
  
  RESULTS
  In univariate analysis (n=293), the hazard ratio (HR) (95% confidence intervals) for dichotomous Ki-67 (≤ 10%, >10%) was 3.42 (1.76, 6.62) χ(2) (1 df)=9.8, P=0.002. In multivariate analysis, Ki-67 added significant predictive information to that provided by Gleason score and prostate-specific antigen (HR=2.78 (1.42, 5.46), χ(2) (1 df)=7.0, P=0.008).
  
  
  CONCLUSIONS
  The IHC Ki-67 scoring on prostate needle biopsies is practicable and yielded significant prognostic information. It was less informative than in the previous TURP cohort where tumour samples were larger and more comprehensive, but in more contemporary cohorts with larger numbers of biopsies per patient, Ki-67 may prove a more powerful biomarker.
authors: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
authors: G
authors: G
authors: Fisher
authors: Z H
authors: ZH
authors: Yang
authors: S
authors: S
authors: Kudahetti
authors: H
authors: H
authors: Møller
authors: P
authors: P
authors: Scardino
authors: J
authors: J
authors: Cuzick
authors: D M
authors: DM
authors: Berney
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D049109:Cell Proliferation; D015331:Cohort Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D060787:Neoplasm Grading; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D017430:Prostate-Specific Antigen