Apoptosis and KI 67 index correlate with preoperative chemotherapy efficacy and better predict the survival of gastric cancer patients with combined therapy.

Purpose: T he correlation of apoptotic and proliferation index with preoperative chemotherapy efficacy was investigated. Their prognostic value was also explored.

Methods: 167 patients were enrolled, curative gastrectomy and D2 lymphadenectomy were performed, and a total of 12 cycles of perioperative mFOLFOX7 chemotherapy was recommended. Apoptosis index (AI) and Ki67 index (KI) in surgical specimens were detected.

Results: Apoptosis index, KI and AI/KI were significantly different between patients received perioperative chemotherapy and surgery (CS group, n = 84) and those who received only surgery and postoperative chemotherapy (S group, n = 83). In the CS group, number of patients who received 2, 4, 6 cycles of preoperative chemotherapy were, respectively, 28, 53 and 3. AI, KI and AI/KI were closely related to pathological response. Cutoff value of AI and AI/KI for response separated CS group patients into two subgroups with significant different prognosis and picked up more potential responders than pathological evaluation, especially in pathological response evaluation grade 1a–b.

Conclusions: Apoptosis index, KI and AI/KI are significantly related to chemotherapy efficacy and prognosis of gastric cancer patients who received perioperative chemotherapy and radical gastrectomy. They could be used in combination with pathological response evaluation to distinguish more potential responders.