Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2025; 16(2): 98423
Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.98423
Clinical significance of Ki-67 in patients with lung adenocarcinoma in situ complicated by type 2 diabetes
Ke Chen, Ge Wang, Jing-Cheng Hu, Ying-Yi Zhou, Hai-Tao Ma
Ke Chen, Hai-Tao Ma, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Ge Wang, Jing-Cheng Hu, Ying-Yi Zhou, Department of Endocrine, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Co-corresponding authors: Ying-Yi Zhou and Hai-Tao Ma.
Author contributions: Ma HT, with a background in thoracic surgery, initially provided the inspiration for the study's design and offered critical guidance during manuscript revisions, enhancing its scientific value; Zhou YY, with expertise in endocrinology, assembled and led the research team, ensuring effective interdisciplinary collaboration; Chen K led the conceptualization, original draft preparation, and formal analysis, and contributed to writing-review and editing; Wang G led the software development and contributed to writing-review and editing; Hu JC led the methodology development and contributed to writing-review and editing. Zhou YY and Ma HT designed the research and served as co-corresponding authors. Zhou YY and Ma HT jointly contributed to writing-review and editing and ensured comprehensive responses to academic queries across disciplines. Ma HT initially provided the inspiration for the study's design, while Zhou YY assembled and led the research team. Given their complementary expertise; Dr. Ma's thoracic surgery background and Dr. Zhou's endocrinology focus co-corresponding authorship ensures comprehensive coverage of the study's multidisciplinary nature. During revisions, Dr. Ma's role as a senior professor provided critical guidance, enhancing the scientific value of the manuscript. Joint corresponding authorship also ensures effective response to academic queries across disciplines, thereby accurately reflecting the shared leadership and key contributions of both researchers.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the institutional review board of The First Affiliated Hospital of Soochow University (No. 2022-459).
Informed consent statement: The informed consent was obtained from all individual participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: Hai-Tao Ma, MD, Doctor, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, No. 188 Shizi Road, Suzhou 215000, Jiangsu Province, China. htma_work@163.com
Received: June 26, 2024
Revised: October 22, 2024
Accepted: December 5, 2024
Published online: February 15, 2025
Processing time: 187 Days and 5.6 Hours
Abstract
BACKGROUND

The increasing number of type 2 diabetes mellitus (T2DM) patients leads to higher rates of morbidity and mortality related to lung cancer.

AIM

To investigate the utility of the proliferating cell nuclear antigen Ki-67 in patients with lung adenocarcinoma in situ (AIS) complicated by T2DM.

METHODS

One hundred patients with AIS and T2DM (group A), 100 patients with AIS alone (group B), and 60 patients with benign lung lesions (group C) admitted to the Department of Thoracic Surgery and Endocrinology of the First Affiliated Hospital of Soochow University from November 2021 to December 2022 were enrolled. Ki-67 expression was compared among the groups.

RESULTS

Group A had significantly higher levels of fasting plasma glucose (FPG), total cholesterol (TC), total triglyceride, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and insulin than groups B and C (P < 0.01). Meanwhile, group B had higher insulin levels than group C (P < 0.01). Group A exhibited a significantly higher average Ki-67 positivity rate than group B (P < 0.01). The Ki-67 positivity rate in group A was 86.87%, while the positivity rate in group B was 77%. Ki-67 was positively correlated with FPG (P < 0.01) and HbA1c levels (P < 0.01). Ki-67, FBG, insulin, HbA1c, high-density lipoprotein cholesterol and TC were independent factors for patients with AIS complicated by T2DM.

CONCLUSION

Ki-67 expression was higher in patients with AIS complicated by T2DM than in patients with AIS alone. Therefore, detecting the Ki-67 level might assist in the diagnosis of AIS in patients with T2DM.

Keywords: Ki-67; Type 2 diabetes mellitus; Lung adenocarcinoma in situ; Immunohistochemistry; Prognostic marker

Core Tip: Type 2 diabetes mellitus (T2DM) is an independent risk factor for lung cancer and increases mortality risk; Ki-67, a proliferation marker, is highly expressed in lung cancer, especially with T2DM; elevated Ki-67 levels in adenocarcinoma in situ (AIS) patients with T2DM suggest its utility as a screening marker. Hyperglycemia and insulin resistance in T2DM may drive cancer progression via the Ras/MAPK and IGF-1 signaling pathways. Regular monitoring of Ki-67, glycosylated hemoglobin, and lipid levels is essential for early detection and better prognosis in patients with AIS and T2DM.