title: Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer.
abstract: The prognostic value of Ki-67 expression, ploidy and s-phase fraction was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded surgical specimens of pancreatic ductal adenocarcinomas were stained with a polyclonal Ki-67 antibody. Ploidy and s-phase fraction was assessed by flow cytometry. The median percentage of Ki-67 positive nuclei was 26% (range 0-90%). The level of Ki-67 immunoreactivity was associated with TNM-stage, surgical resectability, tumour grade, ploidy and S-phase fraction. Ninetythree patients, with a nuclear expression of Ki-67 in < 50% of malignant cells, had a median survival of 12.8 months compared with 5.5 months for 25 patients with Ki-67 > or = 50% (p = 0.0008). Ploidy (p < 0.0001) and SPF (p = 0.002) were also significant prognostic factors in a univariate survival analysis. In a multivariate analysis, stage (or alternatively resectability), grade, ploidy and postoperative chemotherapy emerged as independent prognostic factors. When ploidy was excluded from the Cox multivariate model, S-phase fraction also predicted prognosis independently. Ploidy and S-phase fraction are independent prognostic factors in patients with pancreatic cancer. A high level of Ki-67 immunoreactivity is also an indicator of poor prognosis but seems to add little prognostic information to that provided by traditional parameters such as stage, resectability and grade.
authors.affiliation: Fourth Department of Surgery, Helsinki University Central Hospital, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Lundin
authors.forename: S
authors.initials: S
authors.lastname: Nordling
authors.forename: K
authors.initials: K
authors.lastname: von Boguslawsky
authors.forename: P J
authors.initials: PJ
authors.lastname: Roberts
authors.forename: C
authors.initials: C
authors.lastname: Haglund
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D000951:Antigens, Neoplasm / Q000032:analysis*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D002455:Cell Division; D017024:Chemotherapy, Adjuvant; D004273:DNA, Neoplasm / Q000032:analysis; D005387:Finland / Q000453:epidemiology; D006801:Humans; D019394:Ki-67 Antigen; D015993:Life Tables; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis*; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D016196:S Phase; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins