Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 32-41
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.32
Marker Ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts
Zhen Song, Qi Zhou, Jiang-Lei Zhang, Jun Ouyang, Zhi-Yu Zhang
Zhen Song, Department of Urology, Taixing People’s Hospital, Taizhou 225400, Jiangsu Province, China
Zhen Song, Jiang-Lei Zhang, Jun Ouyang, Zhi-Yu Zhang, Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Qi Zhou, Department of Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Co-first authors: Zhen Song and Qi Zhou.
Author contributions: Zhang ZY designed the research; Song Z, Zhou Q, and Zhang ZY collected and analyzed the data; Song Z and Zhou Q wrote the paper; Zhang JL and Ouyang J provided funding support for this work; Zhang ZY reviewed and revised the paper.
Supported by Suzhou Science and Technology Project, No. SYS2019053.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki (revised in 2013). The study was approved by the ethics committee of the First Affiliated Hospital of Soochow University (No. 119).
Informed consent statement: Informed written consent was obtained from the patient for publication of this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All original raw data of this study can be accessed from https://figshare.com/s/f8b74c6d55ab2f144fdb. Publicly available data were also obtained from the UCSC Xena (https://xena.ucsc.edu/) TCGA database [GDC TCGA Prostate Cancer (PRAD)].
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Yu Zhang, PhD, Doctor, Surgeon, Department of Urology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Gusu District, Suzhou 215000, Jiangsu Province, China. abner_666@126.com
Received: August 21, 2023
Peer-review started: August 21, 2023
First decision: November 28, 2023
Revised: November 30, 2023
Accepted: December 15, 2023
Article in press: December 15, 2023
Published online: January 6, 2024
Abstract
BACKGROUND

Prostate cancer (PCa) is a widespread malignancy, predominantly affecting elderly males, and current methods for diagnosis and treatment of this disease continue to fall short. The marker Ki-67 (MKI67) has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells, including those of PCa. Hence, verifying the association between MKI67 and the diagnosis and prognosis of PCa, using bioinformatics databases and clinical data analysis, carries significant clinical implications.

AIM

To explore the diagnostic and prognostic efficacy of antigens identified by MKI67 expression in PCa.

METHODS

For cohort 1, the efficacy of MKI67 diagnosis was evaluated using data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. For cohort 2, the diagnostic and prognostic power of MKI67 expression was further validated using data from 271 patients with clinical PCa.

RESULTS

In cohort 1, MKI67 expression was correlated with prostate-specific antigen (PSA), Gleason Score, T stage, and N stage. The receiver operating characteristic (ROC) curve showed a strong diagnostic ability, and the Kaplan-Meier method demonstrated that MKI67 expression was negatively associated with the progression-free interval (PFI). The time-ROC curve displayed a weak prognostic capability for MKI67 expression in PCa. In cohort 2, MKI67 expression was significantly related to the Gleason Score, T stage, and N stage; however, it was negatively associated with the PFI. The time-ROC curve revealed the stronger prognostic capability of MKI67 in patients with PCa. Multivariate COX regression analysis was performed to select risk factors, including PSA level, N stage, and MKI67 expression. A nomogram was established to predict the 3-year PFI.

CONCLUSION

MKI67 expression was positively associated with the Gleason Score, T stage, and N stage and showed a strong diagnostic and prognostic ability in PCa.

Keywords: Marker Ki-67, Prostate cancer, Biomarker, Diagnosis, Prognosis

Core Tip: Marker Ki-67 (MKI67) has been established to correlate with the proliferation and metastasis of various malignant tumor cells, including those implicated in prostate cancer (PCa). Our objective is to validate the connection between MKI67 and the diagnosis as well as prognosis of PCa, by deploying two distinct patient cohorts from bioinformatics and clinical data. Within the bioinformatics data cohort, comprising 496 PCa tissue samples juxtaposed with 152 normal controls, we ascertained that MKI67 possesses a strong diagnostic ability for PCa along with a moderate prognostic prediction potential. Similarly, through our retrospective analysis of clinical data from 271 PCa patients, we confirmed the potent diagnostic capacity of MKI67 for PCa and its capability to predict prognosis to a certain extent.