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
Processing time: 134 Days and 2.8 Hours
ARTICLE HIGHLIGHTS
Research background

Prostate cancer (PCa) represents a serious health threat to elderly men as a malignant tumor. Presently, methodologies available for the diagnosis and treatment of PCa are, regrettably, still lacking. Given that marker Ki-67 (MKI67) has been linked with the proliferation and metastasis of PCa cells, it holds substantial clinical meaning to apply both bioinformatics and clinical data to further corroborate the association between MKI67 and the diagnostic and prognostic aspects of PCa.

Research motivation

By establishing the link between MKI67 and PCa, we pave the way for innovative molecular targets and therapeutic approaches for the future diagnosis and treatment of PCa.

Research objectives

To investigate the efficacy of antigen identified by MKI67 expression in the diagnosis and prognosis of PCa.

Research methods

This study undertook a retrospective analysis utilizing both bioinformatics and clinical data. The association between MKI67 expression and various clinicopathological features was assessed using the Wilcoxon rank-sum test. The diagnostic efficacy of MKI67 expression was conveyed via the receiver operating characteristic (ROC) curve. The Kaplan-Meier method was employed to elucidate the progression-free interval (PFI) survival rates in PCa patients. Meanwhile, the time-ROC curve was utilized to predict the 1-, 2-, and 3-year survival rates of the PFI in PCa. Both univariate and multivariate Cox regressions were performed to evaluate the relationship between genetic and clinicopathological characteristics. Lastly, a nomogram was constructed using the rms package.

Research results

In the bioinformatics data, MKI67 expression demonstrated a significant correlation with prostate-specific antigen (PSA), Gleason Score, T stage, and N stage. The ROC curve pointed to a robust diagnostic capacity, while the Kaplan-Meier method indicated that MKI67 expression had a negative correlation with PFI. Moreover, the time-ROC curve exhibited a modest prognostic capability of MKI67 in PCa. In the clinical data, MKI67 expression was significantly tied to the Gleason score, T stage, and N stage, and it was negatively linked to PFI. The time-ROC curve displayed a more substantial prognosis for MKI67 in PCa. A multivariate COX regression analysis was conducted to pinpoint risk factors, which included PSA, N stage, and MKI67 expression. A nomogram was subsequently developed to project 3-year PFI.

Research conclusions

Through comparative analysis of bioinformatics databases and clinical data, MKI67 expression positively correlated with Gleason score and T and N stages, aiding in pinpointing patient’s clinical stages for better treatment planning. MKI67 serves as an efficient diagnostic and prognostic tool for PCa, and a nomogram was constructed for predicting 3-year PFI, enhancing its clinical utility.

Research perspectives

In light of the limitations of this study, future prospective validation is necessitated to confirm the clinical relevance of MKI67 in relation to PCa.