Association Between Ki-67 Proliferative Index and Oncotype-Dx Recurrence Score in Hormone Receptor-Positive, HER2-Negative Early Breast Cancers. A Systematic Review of the Literature.

IF 1.8 Q3 ONCOLOGY Breast Cancer : Basic and Clinical Research Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI:10.1177/11782234241255211
Mehwish Mooghal, Muhammad Ali Akbar Khan, Mirza Rameez Samar, Hafsa Shaikh, Azmina Tajdin Valimohammad, Romana Idrees, Yasmin Abdul Rashid, Abida K Sattar
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Abstract

Background: Oncotype-Dx (ODx) is a 21-gene assay used as a prognostic and predictive tool for hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative, node-negative, or 1 to 3 lymph node-positive early breast cancers (EBCs). The cost of the test, which is not available in low-middle income countries (LMICs), is not within the means of most individuals. The Ki-67 index is a marker of tumor proliferation that is cost-effective and easily performed and has been substituted in many cases to obtain prognostic information.

Objective: We aimed to identify the correlation between the ODx recurrence score (RS) and the Ki-67 index in HR-positive EBCs and to determine whether Ki-67, like the ODx, can help facilitate clinical decision-making.

Design: Systematic review correlating Ki-67 index and ODx in HR-positive and HER2-negative EBCs as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Data sources and methods: We searched different databases between January 2010 and May 2023 and included retrospective/prospective cohorts, clinical trials, case-control, and cross-sectional studies involving HR-positive and HER2-negative EBCs correlating the Ki-67 index and ODx RS categories.

Results: Of the 18 studies included, 16 indicated a positive or weakly positive correlation between ODx and the Ki-67 index. The combined P value of the included studies is <0.05 (P = .000), which shows a statistical significance between the 2. Our review also discusses the potential of machine learning and artificial intelligence (AI) in Ki-67 assessment, offering a cost-effective and reproducible alternative.

Conclusion: Even although there are limitations, studies indicate a favorable association between ODx and the Ki-67 index in specific situations. This implies that Ki-67 can offer important predictive details, especially regarding the likelihood of relapse in HR-positive EBC. This is particularly significant in LMICs where financial constraints often hinder the availability of costly diagnostic tests.

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激素受体阳性、HER2 阴性早期乳腺癌中 Ki-67 增殖指数与 Oncotype-Dx 复发评分之间的关系。文献的系统回顾。
背景:Oncotype-Dx(ODx)是一种 21 基因检测法,用于激素受体(HR)阳性和人类表皮生长因子受体 2(HER2)阴性、结节阴性或 1 至 3 个淋巴结阳性的早期乳腺癌(EBC)的预后和预测。中低收入国家(LMIC)无法提供这种检测,其费用也不是大多数人所能承受的。Ki-67指数是一种肿瘤增殖标志物,成本低、操作简便,在许多病例中被用来替代Ki-67指数,以获得预后信息:我们旨在确定 HR 阳性 EBC 的 ODx 复发评分 (RS) 与 Ki-67 指数之间的相关性,并确定 Ki-67 是否与 ODx 一样有助于促进临床决策:设计:根据《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)指南,对HR阳性和HER2阴性EBC的Ki-67指数和ODx进行相关性系统综述:我们检索了 2010 年 1 月至 2023 年 5 月期间的不同数据库,纳入了涉及 HR 阳性和 HER2 阴性 EBC、与 Ki-67 指数和 ODx RS 分类相关的回顾性/前瞻性队列、临床试验、病例对照和横断面研究:在纳入的 18 项研究中,16 项研究表明 ODx 与 Ki-67 指数呈正相关或弱正相关。我们的综述还讨论了机器学习和人工智能(AI)在 Ki-67 评估中的潜力,它提供了一种具有成本效益和可重复性的替代方法:结论:尽管存在局限性,但研究表明,在特定情况下,ODx 与 Ki-67 指数之间存在有利的关联。这意味着 Ki-67 可以提供重要的预测细节,尤其是关于 HR 阳性 EBC 复发的可能性。这对于经济拮据的低收入国家尤为重要,因为这些国家往往无法获得昂贵的诊断测试。
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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
22
审稿时长
8 weeks
期刊介绍: Breast Cancer: Basic and Clinical Research is an international, open access, peer-reviewed, journal which considers manuscripts on all areas of breast cancer research and treatment. We welcome original research, short notes, case studies and review articles related to breast cancer-related research. Specific areas of interest include, but are not limited to, breast cancer sub types, pathobiology, metastasis, genetics and epigenetics, mammary gland biology, breast cancer models, prevention, detection, therapy and clinical interventions, and epidemiology and population genetics.
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