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Ki67 and P53 in Relation to Disease Progression in Metastatic Pancreatic Cancer: a Single Institution Analysis

  • Original Article
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Pathology & Oncology Research

Abstract

We investigated the expression patterns of Ki67 and p53 in metastatic pancreatic adenocarcinomas and analyzed their relationship with disease progression-free survival (PFS) and overall survival (OS) in the overall study population and in patients treated with a gemcitabine-containing chemotherapy versus FOLFIRINOX chemotherapy. Patients with histologically confirmed stage IV adenocarcinoma of the pancreas treated at AUBMC were included after obtaining institutional review board approval (IRB ID: IM.ST.05). The ROC was plotted to identify the threshold Ki-67, p53 and CA19–9 value for disease progression, the identified value was further used in Kaplan Meier curves to compare PFS for both groups (gemcitabine versus FOLFIRINOX). A value of p < 0.05 was considered significant in all analyses. On univariate analysis, patients who had a Ki-67 > 12.5% or a p53 > 15% had significantly shorter PFS (p = 0.034 and p = 0.016, respectively). This effect was restricted to Gemcitabine or gemcitabine-combination treated patients. A decrease in CA19–9 levels 6–8 weeks after chemotherapy of >58% had significantly longer PFS (p = 0.027). On multivariate analysis after controlling for grade, age and P53, Ki-67 remained significant, for every one unit increase in Ki-67 the progression risk increases by 1.017 times. Our study highlights the negative impact of high P53 expression and Ki67 proliferation index on PFS in patients with metastatic pancreatic cancer.

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Acknowledgements

This work has been funded by the Seed grant from the American University of Beirut.

Funding

This study was funded by the Seed grant from the American University of Beirut.

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Author notes

  1. Sally Temraz and Samer Nassif contributed equally to the work at hand

Authors and Affiliations

  1. Department of internal medicine, division of oncology/hematology, American University of Beirut Medical Center, Riad El Solh, Beirut, 110 72020, Lebanon

    Sally Temraz, Ali Shamseddine, Deborah Mukherji, Arafat Tfayli, Hazem Assi, Miza Salim Hammoud & Iman Makki

  2. Data Management and Clinical Research Unit, American University of Beirut Medical Center, Riad El Solh, Beirut, 110 72020, Lebanon

    Maya Charafeddine

  3. Department of Pathology & Laboratory Medicine, American University of Beirut Medical Center, Riad El Solh, Beirut, 110 72020, Lebanon

    Samer Nassif

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  1. Sally Temraz
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Correspondence to Sally Temraz.

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Conflicts of Interest

The authors report no direct conflicts of interest pertaining to the work. Other conflicts of interest not related to this work are as follows. ST reports receiving payment for development of educational presentations from Merck and travel support from MSD, Amgen and Roche. AS reports having received research grants, honorarium or educational support from Sanofi, Roche, Merck, Bristol Meyer, Amgen, Novartis, MSD and Piere Fabre. DM reports having received honoraria or travel support from Roche, Amgen, Pfizer, MSD and Novartis. MC reports having received research funding from GSK. AT reports having received research grant from Merck serono, travel support from MSK and Roche and consultancy from Pfizer, MSK, Lilly and Novartis. HA reports having received honoraria from Roche, Merck, MSD and AstraZeneca. For the remaining authors none were declared.

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Temraz, S., Shamseddine, A., Mukherji, D. et al. Ki67 and P53 in Relation to Disease Progression in Metastatic Pancreatic Cancer: a Single Institution Analysis. Pathol. Oncol. Res. 25, 1059–1066 (2019). https://doi.org/10.1007/s12253-018-0464-y

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