Pleural mesothelioma (PM), linked to asbestos-induced inflammation, carries a poor prognosis. Therapy ranges from therapy limitation to aggressive multimodality treatment. Given the uncertainty about treatment benefits for patients, this study aimed to assess the role of Ki67 as a prognostic and predictive parameter in PM. Ki67 was measured in the specimens of 70 PM patients (17 female, 53 male) from two centers and correlated to overall survival (OS) and therapy outcome. The median OS was 16.1 months. The level of Ki67 expression was divided into low (≤15%) and high (>15%). A low value of Ki67 expression was associated with a longer OS (Ki67 ≤ 15%: 31.2 (95% CI 6.5–55.8) months vs. Ki67 > 15%: 11.1 (95% CI 7.7–14.6) months,p= 0.012). The 5-year survival represents 22% in the low Ki67 expression group, in contrast to 5% in the high Ki67 expression group. We found a significant interaction term of Ki67 with multimodality treatment (p= 0.031) translating to an OS of 48.1 months in the low expression Ki67 group compared to 24.3 months in the high Ki67 expression group when receiving surgery within multimodality therapy. Therefore, Ki67 stands out as a validated prognostic and, most importantly, novel predictive biomarker for treatment benefits, particularly regarding surgery within multimodality therapy.
胸膜间皮瘤（PM）与石棉暴露引发的炎症相关，预后较差。其治疗策略涵盖从限制性治疗到积极的多模式综合治疗。鉴于治疗对患者获益存在不确定性，本研究旨在评估Ki67作为PM预后及预测指标的作用。研究检测了来自两个中心的70例PM患者（女性17例，男性53例）标本中的Ki67表达水平，并将其与总生存期（OS）及治疗效果进行关联分析。患者中位OS为16.1个月。根据Ki67表达水平分为低表达组（≤15%）和高表达组（>15%）。Ki67低表达与更长的OS显著相关（Ki67 ≤ 15%：31.2个月（95% CI 6.5–55.8） vs. Ki67 > 15%：11.1个月（95% CI 7.7–14.6），p=0.012）。低Ki67表达组的5年生存率为22%，而高表达组仅为5%。研究发现Ki67与多模式治疗存在显著交互作用（p=0.031），在接受多模式治疗中手术干预的患者中，低Ki67表达组OS达48.1个月，显著高于高表达组的24.3个月。因此，Ki67可作为经过验证的预后标志物，更重要的是，它可作为新型预测性生物标志物，用于评估治疗获益，尤其针对多模式治疗中的手术干预策略。
肿瘤(癌症)患者之家