Vol 14: Ki-67 is a valuable prognostic predictor of lymphoma but its utility varies in lymphoma subtypes: evidence from a systematic meta-analysis.Reportar como inadecuado



 Vol 14: Ki-67 is a valuable prognostic predictor of lymphoma but its utility varies in lymphoma subtypes: evidence from a systematic meta-analysis.


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This article is from BMC Cancer, volume 14.AbstractBackground: Ki-67 is a nuclear protein involved in cell proliferation regulation, and its expression has been widely used as an index to evaluate the proliferative activity of lymphoma. However, its prognostic value for lymphoma is still contradictory and inconclusive. Methods: PubMed and Web of Science databases were searched with identical strategies. The impact of Ki-67 expression on survival with lymphoma and various subtypes of lymphoma was evaluated. The relationship between Ki-67 expression and Diffuse Large B Cell Lymphoma DLBCL and Mantle Cell Lymphoma MCL was also investigated after the introduction of a CD-20 monoclonal antibody rituximab. Furthermore, we evaluated the association between Ki-67 expression and the clinical-pathological features of lymphoma. Results: A total of 27 studies met the inclusion criteria, which comprised 3902 patients. Meta-analysis suggested that high Ki-67 expression was negatively associated with disease free survival DFS HR = 1.727, 95% CI: 1.159-2.571 and overall survival OS HR = 1.7, 95% CI: 1.44-2 for lymphoma patients. Subgroup analysis on the different subtypes of lymphoma suggested that the association between high Ki-67 expression and OS in Hodgkin Lymphoma HR = 1.511, 95% CI: 0.524-4.358 was absent, while high Ki-67 expression was highly associated with worse OS for Non-Hodgkin Lymphoma HR = 1.777, 95% CI: 1.463-2.159 and its various subtypes, including NK-T lymphoma HR = 4.766, 95% CI: 1.917-11.849, DLBCL HR = 1.457, 95% CI: 1.123-1.891 and MCL HR = 2.48, 95% CI: 1.61-3.81. Furthermore, the pooled HRs for MCL was 1.981 95% CI: 1.099-3.569 with rituximab and 3.123 95% CI: 2.049-4.76 without rituximab, while for DLBCL, the combined HRs for DLBCL with and without rituximab was 1.459 95% CI: 1.084-2.062 and 1.456 95% CI: 0.951-2.23 respectively. In addition, there was no correlation between high Ki-67 expression and the clinical-pathological features of lymphoma including the LDH level, B symptoms, tumor stage, extranodal site, performance status and IPI score. Conclusions: This study showed that the prognostic significance of Ki-67 expression varied in different subtypes of lymphoma and in DLBCL and MCL after the introduction of rituximab, which was valuable for clinical decision-making and individual prognostic evaluation.



Autor: He, Xin; Chen, Zhigang; Fu, Tao; Jin, Xueli; Yu, Teng; Liang, Yun; Zhao, Xiaoying; Huang, Liansheng

Fuente: https://archive.org/







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