Immunohistochemical markers Ki67 and P16 help predict prognosis in locally advanced cervical cancer.

• Only a small number of studies have reported the impact of Ki-67 and P16 expression in tumour tissue on the prognosis of patients with locally advanced cervical cancer. This study investigated the relationship between Ki-67 and P16 expression levels after neoadjuvant chemotherapy, and the clinical characteristics and prognosis of patients with locally advanced cervical cancer. • 334 patients had a median Ki-67 index of 60 % (0–90 %), with 303 (90.7 %) cases of positive P16 expression and 31 (9.3 %) cases of negative P16 expression. The cut-off value of Ki-67 for determining recurrence was 67.5 % according to the receiver operating characteristic curve analysis. In multi-factorial Cox analysis, lymphatic vascular space (p = 0.003) and Ki-67 index (p = 0.005) were shown to increase the risk of recurrence, and were independent prognostic factors for recurrence. Patients with cervical cancer in the high Ki-67 expression group (Ki-67 ≥ 67.5 %) had lower recurrence-free survival (RFS) and overall survival (OS) than patients in the low Ki-67 expression group (Ki-67 < 67.5 %) (p = 0.001 and 0.036, respectively). • This study provides a theoretical basis for postoperative complementary therapy and follow-up monitoring of this group of patients to control the disease and reduce the risk of recurrence to prolong RFS and OS. To investigate the relationship between Ki-67 and P16 expression levels after neoadjuvant chemotherapy, and the clinicopathological characteristics and prognosis of patients with locally advanced cervical cancer. Patients with FIGO 2009 stage IB2 or IIA2 cervical cancer, who underwent neoadjuvant chemotherapy combined with radical hysterectomy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and December 2019, were identified retrospectively to correlate postoperative Ki-67 and P16 expression levels with clinicopathological factors. The optimal threshold for predicting recurrence was analysed using receiver operating characteristic (ROC) curves for the Ki-67 index, and univariate and multi-factorial Cox regression analysis were used to investigate the association between clinicpathological features including Ki-67 and P16 and recurrence-free survival. In total, 334 patients were included after screening. The cut-off value of Ki-67 for determining recurrence was 67.5 % according to the ROC curve. On multi-factorial Cox analysis, lymphatic vascular space (p = 0.003) and Ki-67 index (p = 0.005) were shown to increase the risk of recurrence, and were independent prognostic factors for recurrence, while the expression of P16 was not significantly associated with the risk of recurrence (p = 0.097, odds ratio = 0.319). Patients with cervical cancer in the high Ki-67 expression group (Ki-67 ≥ 67.5 %) had lower recurrence-free survival and overall survival than patients in the low Ki-67 expression group (Ki-67 < 67.5 %) (p = 0.001 and 0.036, respectively). The expression levels of Ki-67 and P16 after neoadjuvant chemotherapy for locally advanced cervical cancer correlated with tumour differentiation. High expression of Ki-67 (Ki-67 ≥ 67.5 %) may indicate poorer recurrence-free survival and overall survival. [ABSTRACT FROM AUTHOR]