title: New insight into Ki67 expression at the invasive front in breast cancer.
abstract: OBJECTIVE
  To investigate the distribution of Ki67+ cells in breast cancer in relation to clinical-pathological parameters and prognosis.
  
  
  METHODS
  Ki67 expression status was detected in 1,086 breast cancer specimens using immunohistochemistry staining and examining the relationship between the Ki67+ cells' location. Subsequently, clinical-pathological parameters and prognosis were determined.
  
  
  RESULTS
  In total, Ki67 protein expression was found in 781 (71.92%) of the 1,086 breast cancer specimens. Among the 781 Ki67+ cases, 461 were defined as diffuse type and 320 were defined as borderline type. After universal correlation analysis, significant differences were observed in age, histological grade, metastatic nodes, postoperative distant metastasis, and molecular subtype between Ki67+ and Ki67- cases (P = 0.01, 0.001, 0.001, 0.001, and 0.001, respectively). After subgroup analysis, the borderline cases were found to be characterized by a high distant metastasis rate compared to the diffuse cases as well as the Ki67- cases (P = 0.001). No differences were observed between diffuse type or Ki67- cases (P = 0.105). Multivariate analysis showed that age, tumor size, histological grade, lymph node metastasis, molecular subtype, and the Ki67 distribution pattern were observed to be related to postoperative distant metastasis (all P<0.05). Furthermore, borderline type was shown to attain a significantly more distant bone and liver metastasis and worse disease-specific survival than the other types (P = 0.001). In the Cox regression test, the Ki67 distribution pattern was detected as an independent prognostic factor (P = 0.001).
  
  
  CONCLUSIONS
  The distribution pattern of Ki67 may be a new independent prognostic factor for breast cancer.
authors: Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. gongpengdalian@163.com
authors: Peng
authors: P
authors: Gong
authors: Yingxin
authors: Y
authors: Wang
authors: Gavin
authors: G
authors: Liu
authors: Jing
authors: J
authors: Zhang
authors: Zhongyu
authors: Z
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011379:Prognosis
chemical_list: D019394:Ki-67 Antigen
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