Ki-67 proliferation index: correlation with prognostic parameters and outcome in multiple myeloma.
The nuclear protein Ki-67 is a proliferation index, as it is expressed only by dividing cells. In this study, we investigated the clinical significance of Ki-67 determination on bone marrow biopsies of 35 patients with newly diagnosed multiple myeloma (MM). We examined the correlation of Ki-67 with other MM proliferation-related factors: interleukin-6 (IL-6), IL-10, bone marrow infiltration by plasma cells, serum lactate dehydrogenase (LDH), and beta 2 microglobulin (b2M). Ki-67 expression was also correlated with the survival rate of the patients. The results showed that Ki-67 expression increases with increasing stage of disease according to Durie-Salmon (classification stage III vs. I and II, p < 0.001). Furthermore, infiltration, IL-6, LDH, and b2M increase significantly with advancing stage of disease (p < 0.004). All parameters studied were significantly higher in patients versus controls. Ki-67 correlated with IL-6 (r: 0.422, p < 0.01), LDH (r: 0.437, p < 0.01), and b2M (r: 0.478, p < 0.004). There was a marked difference in survival between patients with MM with Ki-67 greater than 8% and patients with Ki-67 less than 8%, in favor of the latter (p < 0.07). We conclude that Ki-67 determination during routine pathological analysis of bone marrow in newly diagnosed MM could provide useful information about the proliferative activity and prognosis of the disease.
Alexandrakis
Michael G
MG
Department of Haematology of the University Hospital of Crete, Greece.
Passam
Freda H
FH
Kyriakou
Despina S
DS
Dambaki
Konstantina
K
Niniraki
Maria
M
Stathopoulos
Efstathios
E
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001853:Bone Marrow / Q000378:metabolism* / Q000473:pathology; D001856:Bone Marrow Examination; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism*; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000378:metabolism
D015415:Biomarkers; D015850:Interleukin-6; D019394:Ki-67 Antigen; D001613:beta 2-Microglobulin; D016753:Interleukin-10; D007770:L-Lactate Dehydrogenase