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    The Effect of Blood Group Phenotypes on the Ki-67 Proliferation Index in Breast Cancer
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2026) Gökdere, Osman Gökhan; Öndeş, Bahadir; Kanat, Burhan Hakan; Kurt, Feyzi
    The Ki-67 proliferation index is an established biomarker reflecting tumor aggressiveness and treatment response in breast cancer. ABO blood group phenotypes have been associated with cancer susceptibility and inflammatory–immunological pathways, yet their potential influence on tumor proliferative behavior remains unclear. This study aimed to investigate the relationship between ABO/Rh blood groups and Ki-67 expression levels in breast cancer. This retrospective study included 189 patients diagnosed with breast malignancy between 2020 and 2024. Ki-67 values were recorded as the percentage of positively stained tumor nuclei. Differences among ABO phenotypes were analyzed using the Kruskal–Wallis test, followed by Dunn post-hoc analysis with Bonferroni correction. Rh groups were compared using the Mann–Whitney U test. All p-values were standardized to three decimal places. A post-hoc power analysis indicated that the sample size (n=189) was adequate to detect a moderate effect size (Cohen’s f=0.25) with 80% power at α=0.05. The overall mean Ki-67 index was 25.9 ± 18.7% (median 22%). Ki-67 levels differed across ABO groups with borderline statistical significance (p=0.060). After Bonferroni correction, the largest differences were observed between group O and groups B/AB (adjusted p=0.078 and p=0.083), suggesting a trend toward higher proliferation in non-O phenotypes. No significant association was detected between Rh factor and Ki-67 levels (p=0.810). Although statistical significance was not reached, patients with blood group O demonstrated lower Ki-67 values, whereas B and AB groups tended to exhibit higher proliferation levels. This pattern may indicate a possible biological influence of ABO antigen expression on tumor proliferation. Larger and multicenter studies are warranted to clarify this potential association. © 2026, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.