Adjustments of  2020csco guidelines make on breast cancer Ki-67 index

Adjustments of  2020csco guidelines make on breast cancer Ki-67 index.  Ki-67 is a nuclear antigen, to be precise, a non-histone protein located in the nucleus.

When a breast cancer patient is diagnosed, doctors will arrange a series of examinations such as pathological examination, imaging examination, and blood test to determine the follow-up treatment plan.

When the patient sees the various letters and symbols on the pathology test, he will be suspicious, and he is also thinking about what the indicators mean?

In addition, many patients will also see a ki-67 on the pathology test report, and doctors will also use this indicator to evaluate the patient’s prognosis. So, what does Ki-67 mean for breast cancer patients? Related reports show that the 2020 coso guidelines have adjusted the ki-67 index for breast cancer. What changes are there?

Ki-67 is a nuclear antigen, to be precise, a non-histone protein located in the nucleus. It generally represents the proliferation index of tumor cells. Ki-67 is expressed in each cycle of cell division, but when the M phase is over, ki-67 will be degraded very quickly (about half an hour later), so cells in the G0 phase do not express ki-67 . Ki-67 is usually expressed as a percentage, ranging from 0% to 100%. The higher the value of ki-67, the more malignant and aggressive the tumor. Some people’s reports do not have a percentage, only a plus sign, ki-67(+), which means that the ratio of positive cells is less than 10%; ki-67(++), which means that the ratio of positive cells is between 10% and 50%; ki-67(+++), which means that the ratio of positive cells is higher than 50%.

So, what are the low and high expressions of ki-67?

In the 2011 St. Gllen International Breast Cancer Treatment Expert Consensus, ki-67-positive cells less than 14% are defined as low-expression positive, and the number of cells greater than 14% is defined as high-expression positive.

The 2020 csco breast cancer guidelines have repositioned the expression of ki-67. The definition of ki-67 threshold should be based on the specific conditions of each laboratory. Most Chinese experts agree that <15% is low expression; >30% is high expression. When ki-67 is 15%-30%, it is recommended to conduct pathological consultation again or make clinical decision based on other indicators.

The above is about the introduction of ki-67 and the latest adjustments, but the follow-up treatment methods need to be comprehensively evaluated, combined with the patient’s clinical stage and other pathological indicators, such as ER, PR, HER2, etc., to determine the patient’s classification And staging to determine whether the follow-up needs to be combined with endocrine therapy, targeted therapy, chemotherapy and other treatment methods.

In addition, the ki-67 index is not static, and certain changes will occur. Patients do not have to worry about the level of an index. The overall treatment effect and prognosis need to be comprehensively evaluated. Patients also need to be treated according to their own medical conditions and physical conditions in accordance with the doctor’s instructions, regular review, develop good living and eating habits, standardize work and rest, maintain a positive and peaceful attitude, and build confidence. Believe that you can definitely overcome the tumor!

(source:internet, reference only)

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