Ki67 testing in the clinical management of patients with non‑metastatic colorectal cancer: Detecting the optimal cut‑off value based on the Restricted Cubic Spline model

Lei,Hong Tao; Yan,Shan; He,Yin Hua; Xu,Ning; Zhao,Min; Yu,Chun Jiao; Li,Hong Lin; Kuang,Sai; Cui,Zhan Hang; Fang,Jing

doi:10.3892/ol.2022.13540

Ki67 testing in the clinical management of patients with non‑metastatic colorectal cancer: Detecting the optimal cut‑off value based on the Restricted Cubic Spline model

Authors:
- Hong Tao Lei
- Shan Yan
- Yin Hua He
- Ning Xu
- Min Zhao
- Chun Jiao Yu
- Hong Lin Li
- Sai Kuang
- Zhan Hang Cui
- Jing Fang
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Affiliations: School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, P.R. China, Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Biomedical Engineering, Kunming Medical University, Kunming, Yunnan 650500, P.R. China, Department of Oncology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650500, P.R. China, Department of Medical Records, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650500, P.R. China, School of Basic Medicine, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
Published online on: October 7, 2022 https://doi.org/10.3892/ol.2022.13540
Article Number: 420
Copyright: © Lei et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The proliferation of the biomarker Ki67 has been extensively studied in colorectal cancer (CRC). Although numerous Ki67 cut‑off values have previously been reported, the optimal cut‑off value remains unclear with previous studies providing contrasting results. The present retrospective cohort study aimed to determine the optimal cut‑off value for CRC. Ki67 levels and the prognosis of patients with non‑metastatic CRC were obtained from the Electronic Health Information System of a tertiary hospital in Kunming City. The Restricted Cubic Spline (RCS) model was used to analyze the non‑linear association between Ki67 levels and the risk of patient death and metastasis. Moreover, the RCS model was used to determine the optimal cut‑off value of Ki67. Cox proportional hazards models were used to verify the effects of the cut‑off value. In total, 210 patients with CRC and a median age of 62.5 years (age range, 23.0‑88.0 years) were studied. Results of the present study demonstrated a non‑linear association between Ki67 levels and the risk of patient death based on the RCS model, and at Ki67 levels ≥60%, the hazard ratio (HR) of patient death gradually increased. Using multivariate‑adjusted Cox proportional hazards models, the results of the present study demonstrated that Ki67 ≥60% indicated a high‑risk ratio for both distant metastasis and death [HR, 2.640; 95% confidence interval (CI), 1.066‑6.539], compared with Ki67 <60% (HR, 2.558; 95% CI, 1.079‑6.064). Therefore, Ki67 ≥60% may be the optimal cut‑off value for the prediction of death and metastasis in patients with CRC. Thus, Ki67 may act as a biomarker for predicting the prognosis of patients with CRC, and the optimal cut‑off value for the prediction of both death and metastasis of patients with CRC is 60%.

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