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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1522009
This article is part of the Research Topic Renewed Insight into Cancer Mechanism and Therapy View all 6 articles

Predicting recurrence of non-muscle invasive bladder urothelial carcinoma: predictive value of the optimal cut-off value of Ki67

Provisionally accepted
Rende Peng Rende Peng 1Mingzhu Jia Mingzhu Jia 2Xinping Yi Xinping Yi 3Xiaoyao Yi Xiaoyao Yi 4Jiangchuan Pi Jiangchuan Pi 1*Wenjun Meng Wenjun Meng 3*
  • 1 Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
  • 2 First Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing Municipality, China
  • 3 Yongchuan Hospital of Chongqing Medical University, Chongqing, China
  • 4 Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

    Objective: To investigate the optimal cut-off value of immunohistochemical marker Ki67 as a prognostic factor to predict the recurrence of non-muscle invasive bladder urothelial carcinoma. Methods: A total of 331 patients diagnosed with NMIBUC who underwent surgery in the Yongchuan Hospital and the Second Affiliated Hospital of Chongqing Medical University from January 2012 to January 2020 were finally included in this study. The optimal cut-off value of Ki67 for predicting recurrence of NMIBUC was calculated by ROC curve and Youden index. According to the cut-off value, the patients were divided into high ratio group and low ratio group, and the clinicopathological data of the two groups were compared. Univariate and multivariate regression analysis were used to analyze the relationship between the expression of Ki67 and postoperative recurrence of NMIBUC. The Kaplan-Meier curve was used for survival analysis. Results: 18% is the optimal cut-off value of Ki67 for predicting postoperative recurrence of NMIBUC. High Ki67 expression (Ki67>18%) was significantly correlated with tumor stage (P=0.001), tumor grade (P=0.014), immediate postoperative instillation (P=0.001), the expression of P53 (P=0.019) and CK20 (P=0.001). Ki67 expression greater than 18% was an independent risk factor for high recurrence rate of NMIBUC (P=0.001). Moreover, the 1-year and 3-year recurrencefree survival (RFS) of the high Ki67 group were 56.6% (95%CI 51.2%-62%) and 43.6% (95%CI 37.5%-49.7%) respectively, which were significantly lower than those in low Ki67 group which present as 92.9% (95%CI 89.0%-96.8%) and 88.3% (95%CI 82.4%-94.2%) respectively, and the difference was statistically significant (P<0.001). Conclusions: 18% is the optimal cut-off value of Ki67 for predicting recurrence of NMIBUC. Ki67>18% is an independent risk factor for high recurrence rate of NMIBUC. This cut-off value can more accurately predict the risk of recurrence and has the potential clinical value for guiding the postoperative adjuvant treatment and followup strategy of NMIBUC.

    Keywords: Immunohistochemical markers, ki67, non-muscular invasive bladder urothelial carcinoma, Recurrence, prognosis, Optimal cut-off value

    Received: 03 Nov 2024; Accepted: 26 Dec 2024.

    Copyright: © 2024 Peng, Jia, Yi, Yi, Pi and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jiangchuan Pi, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan Province, China
    Wenjun Meng, Yongchuan Hospital of Chongqing Medical University, Chongqing, China

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