Growth fractions of human renal cell carcinoma defined by monoclonal antibody Ki-67. Predictive values for prognosis.
BACKGROUND
We used immunohistochemical techniques to elucidate the role of growth fractions of renal cell carcinoma in the clinicopathology of the condition and patient survival.


METHODS
Fifty-two fresh-frozen nephrectomy specimens were immunostained with Ki-67 monoclonal antibody. Ki-67 indexes were determined to examine the relationship between tumor size, grade, stage and survival curve. This study included 43 men and nine women with the mean age 58.4 +/- 11.7 years, who had been followed up for 39 +/- 25 months.


RESULTS
The Ki-67 index ranged from 0.6 to 14.1%, averaging 4.6 +/- 5.8%. It was 2.8 +/- 2.4% in tumors <5 cm, 4.7 +/- 3.6% in tumors > or =5 cm and 7.1 +/- 9.0% in tumors > or =10 cm. The Ki-67 index of grades 1, 2 and 3 tumors was 2.3 +/- 1.1%, 3.3 +/- 2.7% and 12.0 +/- 10.4%, respectively. Grade 3 tumors had a significantly higher Ki-67 index than grade 1 or grade 2 tumors. There was no correlation between the Ki-67 index and tumor stage. Patients with a Ki-67 index < 5.6% had a better prognosis than those with an index > 5.6% (P=0.029). However, multivariate analysis demonstrated that tumor size (P=0.034) and grade (P=0.038) were higher in hazard ratio than the Ki-67 index.


CONCLUSIONS
Most renal cell carcinomas had low growth fractions. Although a high Ki-67 index should indicate a poor prognosis, Ki-67 did not correlate to metastasis. We believe it is necessary to investigate the factors, other than growth potential, that affect metastasis.
Yuba
H
H
Department of Urology, Komaki Shimin Hospital, Chubu National Hospital/National Institute For Longevity Science and Nagoya University School of Medicine, Nagoya, Japan.
Okamura
K
K
Ono
Y
Y
Ohshima
S
S
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D002455:Cell Division; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000276:immunology*; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
D000911:Antibodies, Monoclonal; D019394:Ki-67 Antigen