title: Both cell proliferation and apoptosis significantly predict shortened disease-free survival in hepatocellular carcinoma.
abstract: In this study, we investigated the proliferating cell index by the percentage of Ki-67 expressing cells (Ki-67 LI) and the apoptotic index (AI) by the number of morphologically apoptotic cells per 1000 carcinoma cells in haematoxylin and eosin sections of 76 hepatocellular carcinomas (HCC). Both indices showed excellent correlation with each other (P < 0.0001) and were significantly higher in cases of poor differentiation, of advanced stages, with portal invasion and with intrahepatic metastasis. Furthermore, cases with higher Ki-67 LI or higher AI displayed poor outcomes for disease-free survival (P = 0.0001 and P = 0.0005) by univariate analysis. By multivariate analysis, both indices could be regarded as independent prognostic factors. These results strongly suggest that Ki-67 LI and AI have very similar clinical significance, reflecting the existence of biologically aggressive phenotypes and poor disease-free survival rate in HCC.
authors.affiliation: Department of Surgery II, Osaka University Medical School, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: N
authors.initials: N
authors.lastname: Matsuura
authors.forename: M
authors.initials: M
authors.lastname: Sakon
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: K
authors.initials: K
authors.lastname: Umeshita
authors.forename: H
authors.initials: H
authors.lastname: Nagano
authors.forename: S
authors.initials: S
authors.lastname: Nakamori
authors.forename: K
authors.initials: K
authors.lastname: Dono
authors.forename: M
authors.initials: M
authors.lastname: Tsujimoto
authors.forename: M
authors.initials: M
authors.lastname: Nakahara
authors.forename: K
authors.initials: K
authors.lastname: Nakao
authors.forename: M
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D017209:Apoptosis; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D002455:Cell Division; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D019394:Ki-67 Antigen