Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas
Introduction Since the Fourth edition of the WHO classification, PPGLs have been recognized for their metastatic potential, though no clear features can accurately predict this behavior. The prognostic value of Ki-67 in assessing the risk of progression, relapse, or metastasis in PPGLs remains debat...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2478312 |
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| author | Zilan Luo Xu Yan Yang Liu Fengrui Nan Yuhong Lei Yuan Ren Lingyu Li |
| author_facet | Zilan Luo Xu Yan Yang Liu Fengrui Nan Yuhong Lei Yuan Ren Lingyu Li |
| author_sort | Zilan Luo |
| collection | DOAJ |
| description | Introduction Since the Fourth edition of the WHO classification, PPGLs have been recognized for their metastatic potential, though no clear features can accurately predict this behavior. The prognostic value of Ki-67 in assessing the risk of progression, relapse, or metastasis in PPGLs remains debated.Methods This cohort study included 501 patients diagnosed with PPGLs at the First Hospital of Jilin University between 2000 and 2022, with clinical data, treatment details, pathological indicators, and germline gene test results collected. Bulk sequencing was performed on formalin-fixed paraffin-embedded (FFPE) primary tumor samples from 87 patients. Progression-free survival (PFS) was analyzed using multivariable Cox regression.Results Among the 119 enrolled patients with PPGLs, the average age was 45.7 ± 14.0 years, and the median follow-up time was 46 months. A significant finding was the high expression of CDK1, a gene known to be significantly associated with the metastatic risk of PPGLs, in samples with Ki-67 ≥ 3% (p < 0.0001). More importantly, patients with PPGLs and a Ki-67 level ≥ 3% had a 3.59-fold higher risk of progression, relapse or metastasis compared to those with Ki-67 < 3% (HR = 4.59, 95% CI: 1.06–11.95), after adjusting for all confounding factors. In the composite model, the addition of Ki-67 enhanced the predictive ability of the combined model of SDHB, primary site, tumor size, and invade neighboring tissue (AUC = 0.888, 95% CI: 0.808–0.967 vs. AUC = 0.874, 95% CI: 0.783–0.965).Conclusion A Ki-67 level ≥ 3% is associated with an increased risk of progression, relapse or metastasis in patients with PPGLs. |
| format | Article |
| id | doaj-art-f0630cd79b39445882cdbe62ba0424eb |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-f0630cd79b39445882cdbe62ba0424eb2025-08-20T03:22:15ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2478312Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomasZilan Luo0Xu Yan1Yang Liu2Fengrui Nan3Yuhong Lei4Yuan Ren5Lingyu Li6Cancer Center, The First Hospital of Jilin University, Changchun, ChinaPathology Department, The First Hospital of Jilin University, Changchun, ChinaTumor Immunotherapy Research Center of Jilin University, Changchun, ChinaTumor Immunotherapy Research Center of Jilin University, Changchun, ChinaTumor Immunotherapy Research Center of Jilin University, Changchun, ChinaTumor Immunotherapy Research Center of Jilin University, Changchun, ChinaCancer Center, The First Hospital of Jilin University, Changchun, ChinaIntroduction Since the Fourth edition of the WHO classification, PPGLs have been recognized for their metastatic potential, though no clear features can accurately predict this behavior. The prognostic value of Ki-67 in assessing the risk of progression, relapse, or metastasis in PPGLs remains debated.Methods This cohort study included 501 patients diagnosed with PPGLs at the First Hospital of Jilin University between 2000 and 2022, with clinical data, treatment details, pathological indicators, and germline gene test results collected. Bulk sequencing was performed on formalin-fixed paraffin-embedded (FFPE) primary tumor samples from 87 patients. Progression-free survival (PFS) was analyzed using multivariable Cox regression.Results Among the 119 enrolled patients with PPGLs, the average age was 45.7 ± 14.0 years, and the median follow-up time was 46 months. A significant finding was the high expression of CDK1, a gene known to be significantly associated with the metastatic risk of PPGLs, in samples with Ki-67 ≥ 3% (p < 0.0001). More importantly, patients with PPGLs and a Ki-67 level ≥ 3% had a 3.59-fold higher risk of progression, relapse or metastasis compared to those with Ki-67 < 3% (HR = 4.59, 95% CI: 1.06–11.95), after adjusting for all confounding factors. In the composite model, the addition of Ki-67 enhanced the predictive ability of the combined model of SDHB, primary site, tumor size, and invade neighboring tissue (AUC = 0.888, 95% CI: 0.808–0.967 vs. AUC = 0.874, 95% CI: 0.783–0.965).Conclusion A Ki-67 level ≥ 3% is associated with an increased risk of progression, relapse or metastasis in patients with PPGLs.https://www.tandfonline.com/doi/10.1080/07853890.2025.2478312Ki-67paraganglioma and pheochromocyteprogressionrelapsemetastasis |
| spellingShingle | Zilan Luo Xu Yan Yang Liu Fengrui Nan Yuhong Lei Yuan Ren Lingyu Li Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas Annals of Medicine Ki-67 paraganglioma and pheochromocyte progression relapse metastasis |
| title | Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas |
| title_full | Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas |
| title_fullStr | Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas |
| title_full_unstemmed | Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas |
| title_short | Prognostic significance of Ki-67 in assessing the risk of progression, relapse or metastasis in pheochromocytomas and paragangliomas |
| title_sort | prognostic significance of ki 67 in assessing the risk of progression relapse or metastasis in pheochromocytomas and paragangliomas |
| topic | Ki-67 paraganglioma and pheochromocyte progression relapse metastasis |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2478312 |
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