The role of MIB-1 index in the prognosis of resectable pancreatic head cancer.
OBJECTIVE
Cell kinetics are important indicators of the biological behavior of various human tumors. In this study, we evaluated the prognostic values of the proliferative factors including MIB-1 index, DNA ploidy and S-phase fraction, and further determined the independent prognostic factors in pancreatic head cancer after pancreatoduodenectomy.


METHODS
Patients with pancreatic head cancer undergoing pancreatoduodenectomy were included. Cell proliferative parameters including MIB-1 index, DNA ploidy and S-phase fraction measured by flow cytometry were evaluated and compared with the conventional clinicopathologic factors.


RESULTS
There were 21 resectable pancreatic head cancers. By univariate analysis MIB-1 index, cell differentiation and lymphovascular invasion were significant prognostic factors. The 5-year survival rate was 22.2% for overall patients and 29.2% for patients with MIB-1 < or = 11%, while it was 0% for MIB-1 index > 11%, p=0.011. Tumors without lymphovascular invasion had significantly better prognosis than those with lymphovascular invasion (median survival: 38 vs. 10 months, p=0.009). The median survival was significantly longer for well-differentiated cancers than for moderately and poorly differentiated cancers (44 vs. 11 and 9 months, p=0.038). There was no correlation between the MIB-1 index and the other 2 conventional prognostic factors. After multivariate analysis, only the MIB-1 index emerged as the independent prognostic factor.


CONCLUSIONS
MIB-1 index played a significant role in the prognosis of the resectable pancreatic head cancer and could potentially complement the conventional factors in predicting the prognosis and determining the optimal treatment strategy. MIB-1 index was also an important independent prognostic factor.
Shyr
Y M
YM
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, ROC. ymshyr@vghtpe.gov.tw
Su
C H
CH
Li
A F
AF
Wu
C W
CW
Lui
W Y
WY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor / Q000032:analysis*; D002455:Cell Division / Q000502:physiology*; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D019394:Ki-67 Antigen; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D009687:Nuclear Proteins / Q000032:analysis*; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011003:Ploidies; D011379:Prognosis; D016196:S Phase / Q000502:physiology; D015996:Survival Rate
D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D009687:Nuclear Proteins