Association of KI-67, inflammatory indexes with PET/CT metabolic parameters, prognostic and predictive significance in patients receiving neoadjuvant therapy for locally advanced breast cancer

Objective: Neoadjuvant systemic therapies have generally been discussed in locally advanced breast cancer treatment approaches, but the absolute predictors of treatment response are not clear. In our study, we aimed to evaluate the importance of KI67 and inflammatory parameters at the time of diagnosis and after treatment in predicting response to treatment, predicting prognosis and the correlation of these parameters with metabolic parameters on PET/CT in patients with locally advanced breast cancer receiving neoadjuvant treatment. Materials and Methods: Our study included 117 patients with locally advanced breast cancer who underwent neoadjuvant treatment and then underwent surgery. Laboratory parameters at the time of diagnosis and after treatment, metabolic parameters on PET/CT, pathology at the time of diagnosis and KI-67 value in the pathology specimen after surgery were evaluated. Results: WBC, NE, LY, HGB, PLT, PCT, ALB, PNI and HALP values were statistically significant in patients who received neoadjuvant therapy and then underwent surgery (p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p=0.007; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001; p<0.001, respectively). The change in Ki-67 values of 117 patients included in the study before and after treatment was defined as complete response in patients with a Ki67 value of '0' after treatment, partial response in patients with lower values, and fixed in patients with Ki-67 values of '0' before and after treatment. Accordingly, when the distribution was analyzed, it was found that 40 (34.1%) of the patients were in the complete response group, 44 (37.61%) in the partial response group, and 33 (28.21%) in the fixed group. The predictive level of PNI, HALP and ALB/ALP values of the patients according to the treatment response groups was determined by ROC analysis. According to the analysis, the effect of PNI, HALP and ALB/ALP values on the change in Ki-67 was not statistically significant (p=0.731; p=0.755; p=0.517, respectively). (p>0.05) Conclusion: There are many factors that predict response and determine prognosis in neoadjuvant therapy. KI-67 is an important parameter that determines prognosis in neoadjuvant therapy. The effect of inflammatory parameters on KI-67 in this patient group and the metabolic equivalent of this effect on PET/CT is unclear in breast cancer patients receiving neoadjuvant therapy and comprehensive studies are needed in this regard. Keywords: Ki-67, prognosis, treatment