title: The role of MIB-1 index in the prognosis of resectable pancreatic head cancer.
abstract: 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.
authors.affiliation: Department of Surgery, Veterans General Hospital-Taipei, Taiwan, ROC. ymshyr@vghtpe.gov.tw
authors.forename: Y M
authors.initials: YM
authors.lastname: Shyr
authors.forename: C H
authors.initials: CH
authors.lastname: Su
authors.forename: A F
authors.initials: AF
authors.lastname: Li
authors.forename: C W
authors.initials: CW
authors.lastname: Wu
authors.forename: W Y
authors.initials: WY
authors.lastname: Lui
mesh_terms: 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
chemical_list: D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D009687:Nuclear Proteins