title: Prognostic significance of Ki-67 expression for patients with laryngeal squamous cell carcinoma primarily treated by total laryngectomy.
abstract: The aim of this study was to determine the prognostic value of Ki-67 immunostaining in laryngeal squamous cell carcinomas. Ki-67 labeling was quantified in 63 laryngeal squamous cell carcinomas by counting at least 1,000 tumor cells in the most immunoreactive area in each sample, and the Ki-67 labeling index was calculated as a percentage. The antigen expression was compared with clinical factors, histopathological grading and prognosis. The Ki-67 mean proliferation index for all patients was 25.44% ( range, 2-75%). A significant correlation was found between Ki-67 mean proliferation index and patient age ( P<0.05), T-stage ( P<0.05), nodal metastasis ( P=0.001) and recurrence ( P<0.001). There was no significant association between the Ki-67 mean proliferation index and tumor site or histologic grade. A univariate analysis showed that the Ki-67 labeling index >21% ( P<0.001), T-stage ( P<0.001) and nodal metastasis ( P=0.001) are determinants of recurrence. In the multivariate analysis, the Ki-67 labeling index >21% ( P<0.001), T-stage ( P<0.001) and nodal metastasis ( P<0.05) were independent predictors of recurrence. Kaplan-Meier plots of survival in patients with Ki-67 values above and below the median (21%) of the general study population showed that a high Ki-67 labeling index correlated with a shorter disease-free survival ( P<0.0001). The analysis of the Ki-67 labeling index at the time of initial surgery may be a powerful prognostic marker for patients with laryngeal squamous cell carcinoma and may be useful for selecting subgroups of patients who should be treated with more aggressive therapies.
authors: Department of Pathology, Osmangazi University Medical School, Eskisehir, Turkey. acikalin@ogu.edu.tr
authors: Mustafa Fuat
authors: MF
authors: Acikalin
authors: Ulkü
authors: U
authors: Oner
authors: Nilüfer
authors: N
authors: Tel
authors: Ozgül
authors: O
authors: Paşaoğlu
authors: Hamdi
authors: H
authors: Cakli
authors: Ertuğrul
authors: E
authors: Colak
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D002455:Cell Division; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D007822:Laryngeal Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis
chemical_list: D019394:Ki-67 Antigen