tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2024-14-1-21-29tumors-1291Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSОпределение порогового значения индекса Ki-67 для прогнозирования метастатического поражения лимфатических узлов при раке желудкаDetermination of the Ki-67 threshold value for predicting lymph nodes involvement in patients with gastric cancerhttps://orcid.org/0000-0003-3313-0285АшимовЭ. А.AshimovЕ. А.

Ашимов Эркин Абдиманапович

603163 Нижний Новгород, ул. Деловая, 11/1; 603950 Нижний Новгород, пл. Минина и Пожарского, 10/1

Ashimov Erkin Abdimanapovich

11 / 1 Delovaya str., Nizhnii Novgorod 603163;  10 / 1 sq. Minina i Pozharskogo, Nizhnii Novgorod 603950

ashimov-erkin@mail.ruhttps://orcid.org/0000-0001-6436-3386ЧичеватовД. А.ChichevatovD. А.

Чичеватов Дмитрий Андреевич

440071 Пенза, пр. Строителей, 37А

Chichevatov Dmitry Andreevich

37A ave. Stroiteley, Penza 440071

https://orcid.org/0009-0000-3184-1601РадовскийВ. В.RadovskyV. V.

Радовский Вячеслав Валерьевич

603163 Нижний Новгород, ул. Деловая, 11/1

Radovsky Vyacheslav Valerievich

11 / 1 Delovaya str., Nizhnii Novgorod 603163

https://orcid.org/0000-0002-0859-4339КолесниковаЕ. А.KolesnikovaЕ. А.

Колесникова Елена Александровна

603163 Нижний Новгород, ул. Деловая, 11/1; 603950 Нижний Новгород, пл. Минина и Пожарского, 10/1

Kolesnikova Elena Aleksandrovna

11 / 1 Delovaya str., Nizhnii Novgorod 603163; 10 / 1 sq. Minina i Pozharskogo, Nizhnii Novgorod 603950

https://orcid.org/0009-0009-7832-7728КлиминС. А.KliminS. А.

 Климин Сергей Андреевич

603163 Нижний Новгород, ул. Деловая, 11/1

Klimin Sergey Andreevich

11 / 1 Delovaya str., Nizhnii Novgorod 603163

https://orcid.org/0000-0002-0223-0753ГамаюновС. В.GamayunovS.  V.

Гамаюнов Сергей Викторович

603163 Нижний Новгород, ул. Деловая, 11/1

 Gamayunov Sergey Viktorovich

11 / 1 Delovaya str., Nizhnii Novgorod 603163

https://orcid.org/0000-0002-5769-0378ЗагайновВ. Е.ZagainovV. Е.

Загайнов Владимир Евгеньевич

603163 Нижний Новгород, ул. Деловая, 11/1; 603950 Нижний Новгород, пл. Минина и Пожарского, 10/1

Zagainov Vladimir Evgenevich

11 / 1 Delovaya str., Nizhnii Novgorod 603163; 10 / 1 sq. Minina i Pozharskogo, Nizhnii Novgorod 603950

https://orcid.org/0000-0002-9202-1321КиселевН. М.KiselevN. М.

Киселев Николай Михайлович

603163 Нижний Новгород, ул. Деловая, 11/1; 603950 Нижний Новгород, пл. Минина и Пожарского, 10/1

Kiselev Nikolay Mikhailovich

11 / 1 Delovaya str., Nizhnii Novgorod 603163; 10 / 1 sq. Minina i Pozharskogo, Nizhnii Novgorod 603950

ГАУЗ НО НИИКО «Нижегородский областной клинический онкологический диспансер»; ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияNizhny Novgorod Regional Clinical Oncology Dispensary; Privolzhsky Research Medical UniversityRussian FederationГБУЗ «Областной онкологический диспансер»РоссияRegional Oncology Clinical DispensaryRussian FederationГАУЗ НО НИИКО «Нижегородский областной клинический онкологический диспансер»РоссияNizhny Novgorod Regional Clinical Oncology DispensaryRussian FederationГАУЗ НО НИИКО «Нижегородский областной клинический онкологический диспансер»; ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияNizhny Novgorod Regional Clinical Oncology Dispensary; Privolzhsky Research Medical UniversityRussian Federation2024150320241412129Copyright © Ашимов Э.А., Чичеватов Д.А., Радовский В.В., Колесникова Е.А., Климин С.А., Гамаюнов С.В., Загайнов В.Е., Киселев Н.М., 20242024Ашимов Э.А., Чичеватов Д.А., Радовский В.В., Колесникова Е.А., Климин С.А., Гамаюнов С.В., Загайнов В.Е., Киселев Н.М.Ashimov Е.А., Chichevatov D.А., Radovsky V.V., Kolesnikova Е.А., Klimin S.А., Gamayunov S.V., Zagainov V.Е., Kiselev N.М.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/1291

Поиск биологических маркеров для оценки метастатического поражения лимфатических узлов при раке желудка — одно из ключевых направлений в определении тактики лечения. Роль индекса Ki-67 как маркера клеточной пролиферации при раке желудка остается актуальной. Целью нашего исследования является определение порогового значения индекса Ki-67 при локализованном раке желудка для прогнозирования метастатического поражения лимфатических узлов. Ретроспективный анализ данных 154 больных раком желудка показал независимую и статистически значимую связь глубины инвазии опухоли T (p = 0,002), степени дифференцировки G (p = 0,010), значения индекса Ki-67 (p < 0,0001) с метастатическим поражением лимфатических узлов. С помощью ROC анализа выявлено, что при значении Ki-67 больше или равно 45% получен оптимальный уровень чувствительности (84,2%), специфичности (55,9%) и точности (73,4%) метода AUC 0,738 (p < 0,043; 95% CI 0,654–0,823). При оценке общей выживаемости пациентов с индексом пролиферативной активности в опухоли Ki-67 больше 45% медиана составила 32 месяца [HR 2,2; 95% CI 1,2–3,9; p = 0,005], а при значении Ki-67 меньше 45% медиана общей выживаемости на сегодняшний день не достигнута.

Значение индекса Ki-67 ≥ 45% является оптимальным пороговым значением для определения вероятности метастатического поражения лимфатических узлов при локализованном раке желудка.

The search for biological markers to assess metastatic involvement of the lymph nodes in gastric cancer is one of the key steps in determining treatment tactics. The role of Ki-67 as a marker of cell proliferation in gastric cancer remains relevant. The aim of our study is to determine the Ki-67 threshold value for predicting the lymph nodes metastases. A retrospective analysis of 154 patients with gastric cancer showed an independent and statistically significant relationship between the depth of tumor invasion T (p = 0.002), the differentiation grade G (p = 0.010), the value of the Ki-67 index (p < 0.0001) and metastatic involvement of the lymph nodes. Using ROC analysis we found that Ki-67 ≥ 45 % correlates with the optimal level of sensitivity (55.9 %), specificity (84.2 %) and accuracy (73.4 %) of the method AUC 0.738 (p >< 0.043; 95 % CI 0,654–0,823). When evaluating the overall survival of patients>< 0.0001) and metastatic involvement of the lymph nodes. Using ROC analysis we found that Ki-67 ≥ 45 % correlates with the optimal level of sensitivity (55.9 %), specificity (84.2 %) and accuracy (73.4 %) of the method AUC 0.738 (p < < 0.043; 95 % CI 0,654–0,823). When evaluating the overall survival of patients >0.043; 95 % CI 0,654–0,823). When evaluating the overall survival of patients with Ki-67 > 45 %, we found that the median OS was 32 months [HR 2.2; 95 % CI 1.2–3,9; p = 0.005], while it was not reached in the group with Ki-67 < 45 %.

A Ki-67 level of ≥ 45 % is the optimal threshold for determining the likelihood of lymph node metastasis in gastric cancer.

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The authors declare that there are no conflicts of interest present.