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Prognostic value of Ki-67 index in adult medulloblastoma after accounting for molecular subgroup: a retrospective clinical and molecular analysis

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Abstract

Introduction

Medulloblastoma (MB) is a rare primary brain tumor in adults. We previously evaluated that combining both clinical and molecular classification could improve current risk stratification for adult MB. In this study, we aimed to identify the prognostic value of Ki-67 index in adult MB.

Method

Ki-67 index of 51 primary adult MBs was reassessed using a computer-based image analysis (Image-Pro Plus). All patients were followed up ranging from 12 months up to 15 years. Gene expression profiling and immunochemistry were used to establish the molecular subgroups in adult MB. Combined risk stratification models were designed based on clinical characteristics, molecular classification and Ki-67 index, and identified by multivariable Cox proportional hazards analysis.

Results

In our cohort, the mean Ki-67 value was 30.0 ± 11.3% (range 6.56–63.55%). The average Ki-67 value was significantly higher in LC/AMB than in CMB and DNMB (P = .001). Among three molecular subgroups, Group 4-tumors had the highest average Ki-67 value compared with WNT- and SHH-tumors (P = .004). Patients with Ki-67 index large than 30% displayed poorer overall survival (OS) and progression free survival (PFS) than those with Ki-67 less than 30% (OS: P = .001; PFS: P = .006). Ki-67 index (i.e. > 30%, < 30%) was identified as an independent significant prognostic factor (OS: P = .017; PFS: P = .024) by using multivariate Cox proportional hazards model.

Conclusions

In conclusion, Ki-67 index can be considered as a valuable independent prognostic biomarker for adult patients with MB.

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Funding

This study was supported by Beijing Talents Fund (Grant Number: 2016000021469G216), The Capital Health Research and Development of Special (Grant Number: 2018-2-1073).

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Authors and Affiliations

  1. Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China

    Fu Zhao, Peng Li, Qiangyi Zhou, Bo Wang, Zhijun Yang, Chunde Li & Pinan Liu

  2. Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China

    Fu Zhao, Jing Zhang, Shun Zhang, Chi Zhao, Zhijun Yang, Chunde Li & Pinan Liu

Authors
  1. Fu Zhao
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  2. Jing Zhang
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  3. Peng Li
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  4. Qiangyi Zhou
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  5. Shun Zhang
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  6. Chi Zhao
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  7. Bo Wang
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  8. Zhijun Yang
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  9. Chunde Li
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  10. Pinan Liu
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Contributions

Conception and design: FZ, CL, PL; Provision of study materials and/or patients: ZY, BW; Collection and assembly of data: PL, JZ, QZ; Data analysis and interpretation: CZ, SZ; Manuscript writing: All authors; Final approval of manuscript: All authors.

Corresponding authors

Correspondence to Fu Zhao or Pinan Liu.

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The authors declare that they have no conflict of interest.

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Zhao, F., Zhang, J., Li, P. et al. Prognostic value of Ki-67 index in adult medulloblastoma after accounting for molecular subgroup: a retrospective clinical and molecular analysis. J Neurooncol 139, 333–340 (2018). https://doi.org/10.1007/s11060-018-2865-x

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