title: Prognostic significance of Ki-67 proliferation index in supratentorial fibrillary astrocytic neoplasms.
abstract: Histological grading of fibrillary astrocytic neoplasms has proved to be a valuable prognostic tool, but potentially could benefit from more objective data, such as estimates of proliferative rate. The authors have investigated the prognostic utility of quantitative Ki-67 immunoreactivity in a prospective survival analysis of 36 adult patients with astrocytoma, anaplastic astrocytoma, or glioblastoma multiforme diagnosed between 1987 and 1992. A digital image analyzer was used to assay proliferation indices (PIs) in surgical biopsy specimens obtained at first diagnosis (32 of 36) or at a second biopsy of histologically unchanged high-grade disease (4 of 36). A Ki-67 PI of > or = 7.5% was associated with higher histological grade and poorer survival, and the Ki-67 PI was more significantly related to survival (P < 0.001) than histological grade as determined by a modified Ringertz grading system (P = 0.002). Survival analysis within histological grades suggested that astrocytoma patients with PI > or = 3% may be at increased risk for shorter survival than those with PI < 3%.
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, North Carolina.
authors.forename: T J
authors.initials: TJ
authors.lastname: Montine
authors.forename: J J
authors.initials: JJ
authors.lastname: Vandersteenhoven
authors.forename: A
authors.initials: A
authors.lastname: Aguzzi
authors.forename: O B
authors.initials: OB
authors.lastname: Boyko
authors.forename: R K
authors.initials: RK
authors.lastname: Dodge
authors.forename: B J
authors.initials: BJ
authors.lastname: Kerns
authors.forename: P C
authors.initials: PC
authors.lastname: Burger
mesh_terms: D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics*; D001921:Brain / Q000473:pathology; D002455:Cell Division / Q000235:genetics* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D006801:Humans; D019394:Ki-67 Antigen; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D009687:Nuclear Proteins / Q000235:genetics*; D015173:Supratentorial Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins