RESUMO

AIM: This study aimed to examine the prognostic significance of the KI-67 proliferation index, especially in breast cancer (BC) patients without HER-2 expression and no nodal involvement. MATERIAL AND METHODS: The database of hormone-receptor-positive patients who underwent surgery for BC in our Surgical Oncology Clinic between 2008 and 2020 was retrospectively reviewed and recorded. Patients were categorized based on their KI-67 level, considering the cutoff value of 20%. RESULTS: Our study revealed that tumors with high KI-67 levels were more likely to have a more advanced histological grade (p = 0.00) and size (p = 0.038). In the univariant analysis, KI-67 level was effective on overall survival (p = 0.044) and disease-free survival (p = 0.048). However, we found that there was no independent prognostic factor in the multivariant analysis. CONCLUSION: Although the Ki-67 proliferation index does not yet have an agreed threshold value and scoring methodology, it can also be used to determine prognosis and evaluate treatment response in some patients.

---

OBJETIVO: Este estudio tuvo como objetivo examinar la importancia pronóstica del índice de proliferación KI-67, especialmente en pacientes con cáncer de mama sin expresión de HER-2 y sin compromiso ganglionar. MATERIAL Y MÉTODOS: Se revisó y registró retrospectivamente la base de datos de pacientes con receptores hormonales positivos intervenidas de cáncer de mama en nuestra Clínica de Oncología Quirúrgica entre 2008 y 2020. Las pacientes fueron categorizadas de acuerdo con su nivel de KI-67, considerando el valor de corte del 20%. RESULTADOS: Nuestro estudio reveló que los tumores con valores elevados de KI-67 eran más propensos a tener un grado histológico (p = 0.00) y un tamaño (p = 0.038) más avanzados. En el análisis univariado, el nivel de KI-67 fue efectivo sobre la supervivencia global (p = 0.044) y la supervivencia libre de enfermedad (p = 0.048). Sin embargo, encontramos que no había ningún factor pronóstico independiente en el análisis multivariante. CONCLUSIONES: Aunque el índice de proliferación Ki-67 aún no tiene un valor de umbral acordado ni una metodología de puntuación, también se puede utilizar para determinar el pronóstico y evaluar la respuesta al tratamiento en algunas pacientes.

Assuntos

Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/metabolismo , Prognóstico , Antígeno Ki-67 , Estudos Retrospectivos , Proliferação de Células , Biomarcadores Tumorais

RESUMO

INTRODUCTION: There are several factors predicting evolution in carcinoid tumors (CT) to date including the Ki67 role. AIMS: The aim of this study is to identify a KI67 cut-off point for a population of CT and determine its prognostic implication in global and disease-free survival. METHODS: Hematoxylin-eosin slides of 102 CT were revised. The percentage of cells expressing Ki 67 was determined manually. STATISTICAL ANALYSIS: The variables were compared with the t-test or the Wilcoxon test according to their distribution, the categorical ones with Chi-square or Fisher's test. The best cut-off point was established by constructing receiver operating characteristic curves, then using that value as a dichotomous variable. RESULTS: 72 typical carcinoids (TC) and 30 atypical carcinoids (AC) were analyzed; 66% were female. Median age (TC 38 vs. AC 51, P = 0.001), Ki67 expression (TC 0.63 vs. AC 2, P = 0.003), tumor size (TC 2.5 vs. AC 2.6, P = 0.001), the percentage relapse (TC 3.4% vs. AC 23%, P = 0.006), and the number of deaths (TC 1 vs. AC 4, P = 0.042) were significantly higher in the AC subgroup. The best cut-off point for Ki 67 was 0.755 (area under the curve AUC 0.564, 95% confidence interval 0.270-0.857), with no significant differences found in the disease-free and overall survival curves when considering values < or ≥ at the established cut-off point. The best cut-off point of the Ki-67 when exclusively analyzing AC was 1.18. When using this value as a predictive variable, a marginal statistical association was observed between Ki-67 expression, mortality (P = 0.077), and the frequency of relapses (P = 0.054). CONCLUSIONS: Histological type is the best predictor of prognosis in the carcinoid tumor group. In the AC subgroup, the marginal association between mortality, frequency of relapses and Ki values 67 ≥ 1.18 has clinical relevance future analyses are required to determine the real predictive value of this variable.

RESUMO

PURPOSE: Gastrointestinal stromal tumors (GIST) have the potential to recur and metastasize. Several prognostic schemes have been developed but none are precise enough and most times the pathologist faces a small biopsy where it is not possible to evaluate the mitotic count. Our aim was to determine the influence of ki67 index and other clinicopathologic characteristics in the recurrence of GIST. METHODS: Forty-three consecutive cases of GIST were studied. The cases presented with non-metastatic disease. We compared the clinicopathologic features of cases with recurrence against those with non-recurrence. The ki67 index was determined by square-millimeters. RESULTS: The median age was 55 years (IQR 45-63), the most frequent site of involvement was the stomach with 21 (48.8%) cases, and the median of tumor diameter was 10 cm (IQR 5.5-17.5). Twenty-six (60.5%) cases were spindle cell, 13 (30.2%) were mixed, and 4 (9.3%) were epithelioid. The median mitosis count for 50 high power fields was 4 (IQR 0-16), while per square millimeter it was 1 (IQR 0-5, range 0-32). The median of the ki67 proliferation index was 5% (IQR 1-20). During the period of study, 11 (25.6%) patients recurred. The only significant differences between patients with GIST with recurrence and without recurrence were the sex and tumor size. CONCLUSION: We did not find an association of the ki67 index with recurrence. The factors associated with recurrence were a high tumor size (> 10 cm) and male sex.

Assuntos

Tumores do Estroma Gastrointestinal/patologia , Antígeno Ki-67/análise , Recidiva Local de Neoplasia/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Estudos Transversais , Feminino , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/prevenção & controle , Prognóstico , Fatores Sexuais , Estômago/patologia , Estômago/cirurgia

RESUMO

Ki-67 has shown promise as a prognostic factor in pulmonary carcinoids. In this study, we sought to validate the importance of Ki-67 and study the relationships between Ki-67 and other stromal biomarkers of vascular density. We examined Ki-67, CD34, and D2-40 in tumor tissues from 128 patients with surgically excised typical carcinoid of the lung. We used immunohistochemistry and morphometry to evaluate the amount of tumor staining for cellular proliferation (Ki-67), microvascular density (CD34-MVD), and D2-40 lymphovascular density. The main outcome was overall survival, considered as life expectancy until death from metastasis. Specimens from patients with central tumors showed high CD34-MVD (P = .01), which was also significantly associated with a compromised surgical margin, lymph node metastasis, and clinical stage Ib. Equally significant was high D2-40 lymphovascular density in central specimens with a compromised surgical margin and lymph node metastasis. A high Ki-67 proliferation rate was significantly associated with tumors from patients with clinical stage IIb, IIIa, and IV disease. Multivariate Cox model analysis demonstrated that tumor location and stage, surgical margin, tumor size, and N stage were significantly related to survival time (P < .05). Quantitative staining of the tumor for Ki-67 and CD34-MVD served as prognostic factors (P < .05), which were more relevant than the surgical and pathological stage. Ki-67 greater than 5% and CD34-MVD greater than 7% staining comprise a subset of patients with higher death hazard; this outcome may harbor evidence for further prospective studies of target therapy after surgical resection.

Assuntos

Anticorpos Monoclonais Murinos/imunologia , Antígenos CD34/análise , Capilares/química , Tumor Carcinoide/química , Proliferação de Células , Imunoquímica/métodos , Antígeno Ki-67/análise , Neoplasias Pulmonares/química , Linfangiogênese , Vasos Linfáticos/química , Neovascularização Patológica , Adolescente , Adulto , Idoso , Capilares/patologia , Tumor Carcinoide/mortalidade , Tumor Carcinoide/secundário , Tumor Carcinoide/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Metástase Linfática , Vasos Linfáticos/patologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pneumonectomia , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Carga Tumoral , Adulto Jovem

RESUMO

Canine malignant mammary gland tumours were surgically resected from 78 dogs to determine the prognostic value of Ki 67 Proliferation antigen. After post surgical follow up for minimum of 1 year, 48 dogs were still alive, while 21 dogs had died as a consequence of malignancy, while remaining nine dogs showed recurrence of tumour. Formalin fixed, paraffin wax embedded histological sections were immunostained with monoclonal antibody Ki 67 (MIB -1). At least 100 cells in eight to 10 representative fields were counted. The Ki 67 index was expressed as the percentage of positive cells. In malignant canine mammary gland tumours, Ki 67 index ranged from 2.23 to 26.34 (14.45 ± 0.51). A statistically significant difference in the Ki 67 index (P< 0.05) was found between alive and dead group of dogs. Ki 67 index correlated with histological staging as most tumours in stage II had higher Ki 67 index and showed tumour related deaths. A clear association between the death due to malignancy and Ki 67 index was evident using Ki 67 index median count cut off value of 14.27 Thus Ki 67 index was good indicator of malignancy and dogs having Ki67 index greater than 14.27 have poor prognosis for mammary gland tumours.(AU)

Assuntos

Animais , Cães , Neoplasias Mamárias Animais/diagnóstico , Glândulas Mamárias Animais/fisiopatologia , Prognóstico , Proliferação de Células/fisiologia

RESUMO

Canine malignant mammary gland tumours were surgically resected from 78 dogs to determine the prognostic value of Ki 67 Proliferation antigen. After post surgical follow up for minimum of 1 year, 48 dogs were still alive, while 21 dogs had died as a consequence of malignancy, while remaining nine dogs showed recurrence of tumour. Formalin fixed, paraffin wax embedded histological sections were immunostained with monoclonal antibody Ki 67 (MIB -1). At least 100 cells in eight to 10 representative fields were counted. The Ki 67 index was expressed as the percentage of positive cells. In malignant canine mammary gland tumours, Ki 67 index ranged from 2.23 to 26.34 (14.45 ± 0.51). A statistically significant difference in the Ki 67 index (P 0.05) was found between alive and dead group of dogs. Ki 67 index correlated with histological staging as most tumours in stage II had higher Ki 67 index and showed tumour related deaths. A clear association between the death due to malignancy and Ki 67 index was evident using Ki 67 index median count cut off value of 14.27 Thus Ki 67 index was good indicator of malignancy and dogs having Ki67 index greater than 14.27 have poor prognosis for mammary gland tumours.