A High Ki67/BCL2 Index Could Predict Lower Disease-Free and Overall Survival in Intestinal-Type Gastric Cancer

Eur Surg Res. 2017;58(3-4):158-168. doi: 10.1159/000448945. Epub 2017 Mar 9.

Abstract

Background: The heterogeneity of gastric cancer makes the identification of potential prognostic indicators particularly important. The Ki67 and BCL2 proteins are known prognostic markers for different types of cancer. Ki67 is associated with cell proliferation, whereas BCL2 has antiproliferative roles. A combined marker based on these opposite functions might provide improved prognostic information in gastric cancer.

Method: Ki67 and BCL2 expression was assessed in 276 gastric adenocarcinoma tissue microarrays. A Ki67/BCL2 index based on the relative expression of each protein was divided into low- and high-risk groups using receiver operating characteristic curves.

Results: A high Ki67/BCL2 index significantly correlated with advanced stage, recurrence, intestinal type, high histologic grade, and lymphatic and perineural invasion (all p < 0.05). Univariate and multivariate analyses revealed a significant relationship between disease-free or overall survival and the Ki67/BCL2 index in intestinal-type gastric cancer (all p < 0.05).

Conclusions: A combined marker using Ki67 and BCL2 could be a useful indicator for predicting survival in patients with intestinal-type gastric cancer.

Keywords: Adenocarcinoma; Human; Ki67 antigen; Prognosis; Stomach; bcl-2 homologous antagonist/killer protein.

MeSH terms

  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Aged
  • Disease-Free Survival
  • Female
  • Humans
  • Ki-67 Antigen / metabolism*
  • Male
  • Neoplasm Metastasis
  • Proto-Oncogene Proteins c-bcl-2 / metabolism*
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Stomach / pathology
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology

Substances

  • BCL2 protein, human
  • Ki-67 Antigen
  • Proto-Oncogene Proteins c-bcl-2