Frontiers in medicine · 2026
Study on the predictive efficacy of Ki-67, ER, and PR levels on the effectiveness of neoadjuvant chemotherapy in breast cancer.
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Lin Lin, Han Bing
Аннотация
AIM: To investigate the predictive efficacy of Ki-67 antigen (Ki-67), estrogen receptor (ER), and progesterone receptor (PR) levels on the effectiveness of neoadjuvant chemotherapy (NAC) in breast cancer.
METHODS: A total of 720 breast cancer patients receiving NAC at our hospital from September 2022 to December 2024 were selected. Based on efficacy assessment results, they were divided into a responder group (536 cases) and a non-responder group (184 cases). Clinical data were collected for both groups, and the expression of Ki-67, ER, and PR in cancer tissues was detected to compare their differences. Logistic analysis was used to examine the impact of Ki-67, ER, and PR on NAC effectiveness. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of Ki-67, ER, and PR levels on NAC outcomes.
RESULTS: There was no significant difference in age and BMI between the two groups (p > 0.05); however, significant differences were observed in clinical stage and molecular subtype (p < 0.05). The expression of Ki-67, ER, and PR also differed significantly between the two groups (p < 0.05). Clinical stage (III), ER positivity, and PR positivity were identified as independent risk factors for NAC ineffectiveness (poor response), while high Ki-67 expression was an independent predictor of favorable response to NAC (p < 0.05). The combined detection of Ki-67+ER+PR showed higher area under the curve (AUC), sensitivity, and specificity in predicting NAC effectiveness compared to individual detection of Ki-67, ER, or PR. The combined Ki-67+ER+PR model achieved an AUC of 0.853 (95% CI 0.817-0.884), with a sensitivity of 82.1% and a specificity of 78.9%, clearly outperforming Ki-67 alone (AUC 0.786) as well as ER and PR alone (AUC 0.652 and 0.638, respectively).
CONCLUSION: The levels of Ki-67, ER, and PR before NAC treatment in breast cancer patients were associated with NAC efficacy. A combined Ki-67+ER+PR model showed better apparent discrimination than any single marker in this cohort, but its added clinical value over Ki-67 alone appears incremental and requires further validation before it can be used as a stand-alone clinical decision-making tool.
METHODS: A total of 720 breast cancer patients receiving NAC at our hospital from September 2022 to December 2024 were selected. Based on efficacy assessment results, they were divided into a responder group (536 cases) and a non-responder group (184 cases). Clinical data were collected for both groups, and the expression of Ki-67, ER, and PR in cancer tissues was detected to compare their differences. Logistic analysis was used to examine the impact of Ki-67, ER, and PR on NAC effectiveness. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of Ki-67, ER, and PR levels on NAC outcomes.
RESULTS: There was no significant difference in age and BMI between the two groups (p > 0.05); however, significant differences were observed in clinical stage and molecular subtype (p < 0.05). The expression of Ki-67, ER, and PR also differed significantly between the two groups (p < 0.05). Clinical stage (III), ER positivity, and PR positivity were identified as independent risk factors for NAC ineffectiveness (poor response), while high Ki-67 expression was an independent predictor of favorable response to NAC (p < 0.05). The combined detection of Ki-67+ER+PR showed higher area under the curve (AUC), sensitivity, and specificity in predicting NAC effectiveness compared to individual detection of Ki-67, ER, or PR. The combined Ki-67+ER+PR model achieved an AUC of 0.853 (95% CI 0.817-0.884), with a sensitivity of 82.1% and a specificity of 78.9%, clearly outperforming Ki-67 alone (AUC 0.786) as well as ER and PR alone (AUC 0.652 and 0.638, respectively).
CONCLUSION: The levels of Ki-67, ER, and PR before NAC treatment in breast cancer patients were associated with NAC efficacy. A combined Ki-67+ER+PR model showed better apparent discrimination than any single marker in this cohort, but its added clinical value over Ki-67 alone appears incremental and requires further validation before it can be used as a stand-alone clinical decision-making tool.