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The Use of CD44 Variant 9 and Ki-67 Combination Can Predicts Prognosis Better Than Their Single Use in Early Gastric Cancer

Cancer Research and Treatment 2019년 51권 4호 p.1411 ~ 1419
 ( Go Se-Il ) - Gyeongsang National University School of Medicine Gyeongsang National University Changwon Hospital Department of Internal Medicine

 ( Ko Gyung-Hyuck ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Pathology
 ( Lee Won-Sup ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Internal Medicine
 ( Lee Jeong-Hee ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Pathology
 ( Jeong Sang-Ho ) - Gyeongsang National University School of Medicine Gyeongsang National University Changwon Hospital Department of Surgery
 ( Lee Young-Joon ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Surgery
 ( Hong Soon-Chan ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Surgery
 ( Ha Woo-Song ) - Gyeongsang National University School of Medicine Gyeongsang National University Hospital Department of Surgery

Abstract


Purpose: We previously demonstrated that CD44v9 and Ki-67 played an important role in predicting poor prognosis of early gastric cancer (EGC). However, little is known about combined use of both biomarkers as prognostic biomarker. The present study was performed to investigate the significance of CD44v9 and Ki-67 expression as a combination biomarker for EGC.

Materials and Methods: With tissue microarray for 158 EGC tissues, we performed immunohistochemical staining for CD44v9 and Ki-67. The whole patients were divided into three groups (group A, CD44v9-negative/Ki-67?low; group B, neither group A or C; and group C, CD44v9-positive/Ki-67?high). Its clinical significance was re-analyzed with adjustment via propensity score matching (PSM). For validation, we performed bootstrap resampling.

Results: The median follow-up duration was 90.4 months (range, 3.7 to 120.4 months). In the comparison according to CD44v9/Ki-67 expression, the combined use of the two biomarker clearly separated the three groups by 5-year survival rates (5-YSR, 96.3%, 89.8%, and 76.8% in group A, B, and C, respectively; p=0.009). After PSM, 5-YSR were 97.7% and 76.8% in group A+B and group C, respectively (p=0.002). Multivariable analysis demonstrated that group C had independently poor prognosis (hazard ratio, 9.137; 95% confidence interval, 1.187 to 70.366; p=0.034) compared with group A. Bootstrap resampling internally validated this result (p=0.016).

Conclusion: This study suggests that both positive CD44v9 and high Ki-67 expression are associated with poor prognosis in EGC, and the combined use of these markers provides better prognostic stratification than the single use of them.

키워드

CD44v9 antigen; Ki-67 antigen; Stomach neoplasm; Prognosis
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