title: Ki-67 (clone MIB-1) proliferation index in recurrent glial neoplasms: no prognostic significance.
abstract: BACKGROUND
  To determine if the Ki-67 (MIB-1 clone) proliferative index (PI) has prognostic potential in patients with recurrent astroglial neoplasms.
  
  
  METHODS
  We conducted a retrospective review of 27 patients whose initial and recurrent specimens were available. Histopathology was determined according to the World Health Organization classification. Proliferation index was calculated on formalin-fixed tissue using the Ki-67 (MIB-1 clone) antibody. Morphometric data were analyzed in conjunction with clinical data and Cox Proportionate Hazards Analysis, Spearman's correlation coefficient and Mann-Whitney Test.
  
  
  RESULTS
  Initial histopathology included 14 glioblastoma multiforme, 7 anaplastic astrocytoma, 3 oligoastrocytoma, and 3 astrocytoma. Recurrent specimens showed changes consistent with treatment. While univariate analysis shows initial histology correlated with survival (p<0.036), PI did not correlate with survival after either initial (p = 0.86) or recurrent (p = 0.46) surgery for any tumor type. PI difference between specimens also did not correlate with survival (p = 0.91). Initial PI did not correlate with recurrent PI either (p = 0.43).
  
  
  CONCLUSIONS
  Ki-67 PI does not confer additional prognostic information for patients with recurrent astroglial neoplasms. One possible explanation for this observation is that treatment may alter the PI independent of its effect on tumor growth.
authors.affiliation: Division of Neurosurgery, University of Massachusetts Medical School, Worcester, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Litofsky
authors.forename: T C
authors.initials: TC
authors.lastname: Mix
authors.forename: S P
authors.initials: SP
authors.lastname: Baker
authors.forename: L D
authors.initials: LD
authors.lastname: Recht
authors.forename: T W
authors.initials: TW
authors.lastname: Smith
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal; D001254:Astrocytoma / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D001932:Brain Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D002455:Cell Division; D006801:Humans; D019394:Ki-67 Antigen; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D019394:Ki-67 Antigen