MKI67 is a potential biomarker for prostate cancer in diagnosis and prognosis based on two cohorts

Objective: To explore the efficacy of diagnosis and prognosis of the marker of proliferation Ki-67(MKI67) expression in prostate cancer (PCa). Methods: In cohort 1, the efficacy of diagnosis of MKI67 was evaluated by the Wilcoxon rank-sum test and ROC curve using the data from the TCGA database and GTEx database. Then the relationship between MKI67 expression and clinicopathological characteristics was analyzed through Wilcoxon rank-sum test. Next, the ability of prognosis of MKI67 expression for 1-Year, 2-Year, 3-Year of progress free interval (PFI) was assessed by the Kaplan-Meier method and time-ROC curve. In cohort 2, the diagnostic and prognostic power of MKI67 expression was further validated with data from 271 clinical PCa patients. Finally, a nomogram was created to predict 3-year PFI in BCR based on COX regression results. Results: In cohort 1, MKI67 expression correlated with PSA, Gleason Score, T stage, and N stage (p<0.05). The ROC curve showed a strong ability to diagnose (AUC=0.844) and the Kaplan-Meier method demonstrated MKI67 expression was negatively associated with PFI (HR=1.91, p=0.003). And the time-ROC curve displayed the weak capability of prognosis (1-Year, AUC=0.672; 2-Year, AUC=0.624; 3-Year, AUC=0.613) of MKI67 in PCa. In cohort 2, MKI67 expression was significantly related to Gleason Score, T stage, and N stage (p<0.05) while negatively associated with PFI (HR=9.23, p<0.001). The time-ROC curve exhibited a stronger capability of prognosis (1-Year, AUC=0.868; 2-Year, AUC=0.857; 3-Year, AUC=0.874) of MKI67 in PCa. The multivariate analysis of COX regression was performed to select the risk factors, including PSA, N Stage, and MKI67 expression (p<0.05). And a nomogram was established to predict the 3-Year PFI based on the outcomes. Conclusions: MKI67 expression was positively associated with Gleason Score, T stage, and N stage and showed a strong ability of diagnosis and prognosis of PFI of PCa.