Human Cell

, Volume 32, Issue 2, pp 172–184 | Cite as

KLP-PI: a new prognostic index for luminal B HER-2-negative breast cancer

  • Chuanmeng Pan
  • Adheesh Bhandari
  • Yehuan Liu
  • Erjie Xia
  • Lizhi Lin
  • Shixu LvEmail author
  • Ouchen WangEmail author
Research Article


Luminal B HER-2-negative (LBHN) subtype is one of the major subtypes of breast cancer according to different features, clinical behaviors, and treatment response. The LBHN subtype shows a poor prognosis and is insensitive to endocrine therapy. Our work aim is to investigate the prognostic factor in the LBHN subgroup and, meanwhile, try to obtain an optimal prognostic index (PI) contrapose LBHN subgroup which helps to guide chemotherapy. A total of 515 female LBNH patients who underwent diagnosis and surgery at our hospitals from August 2008 to August 2018 were enrolled. Clinical–pathological information was obtained and immunohistochemistry result was available. From these cases, a 30% Ki-67 LI was employed to divide LBHN into two groups with low and high levels; high Ki-67 LI was associated with GIII tumor grade (P < 0.001), positive axillary lymph nodes (ALN) status (P = 0.018) and negative PR status (P = 0.016), and also seemed to be related to T2–T3 tumor size (P = 0.058). High Ki-67 level (HR = 3.30; P < 0.011), positive ALN (HR = 7.29; P < 0.001) and PR negative (HR = 2.63; P = 0.034) significantly associated with poor 5-year DFS in multivariate Cox’s proportional hazard regression model. A novel prognosis prediction model (KLP-PI), based on Ki-67 LI, ALN and PR status, showed a better discriminatory ability compared with traditional Nottingham prognostic index targeted to LBHN breast cancer. Our study highlights that high Ki-67 LI, positive ALN and negative PR status were associated with poor outcome in LBHN patients, and composed by these prognostic factors, KLP-PI improves the prognostic assessment using the Nottingham Prognostic Index when aiming at LBHN subtype.


Breast cancer Luminal B HER-2 negative Ki-67 Prognostic index Axillary lymph nodes PR status 



We would like to thank all the doctors of the Department of Thyroid and Breast Surgery of First Affiliated Hospital of Wenzhou Medical University for providing the necessary information required for our study. Without their help, this article would not have been possible. This study was supported by the Key Project of Science and Technology Innovation Team of Zhejiang Province (2013TD10) and National Natural Science Foundation of China (Number 81372380).

Compliance with ethical standards

Ethics approval and consent to participate

This study was subject to approval by the Ethics Committee Board of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China.

Consent for publication

Written informed consent was issued by the patients for the publication of this study. A copy of the written consent is ready for review by the Editor in Chief of this journal.

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Japan Human Cell Society and Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgeryThe Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhouPeople’s Republic of China
  2. 2.Department of Thyroid and Breast SurgeryThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouPeople’s Republic of China

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