title: Ki-67 expression in non-tumour epithelium adjacent to oral cancer as risk marker for multiple oral tumours.
abstract: OBJECTIVE
  The aim of this study was to determine whether the differential assessment of epithelial proliferation is useful to diagnose premalignant fields and assess the risk of multiple tumours.
  
  
  METHODS
  We analysed 83 oral carcinomas with associated non-tumour epithelium classified as distant or close according to its distance (> or <1 cm) from the invasion point, and as squamous hyperplasia, mild, moderate, severe dysplasia or carcinoma in situ. Twenty-five healthy oral mucosa samples were used as controls. An immunohistochemical technique was applied using Mib-1. Ki-67 in premalignant epithelium was assessed in basal layer, parabasal layer, medium and upper third.
  
  
  RESULTS
  Parabasal expression was significantly higher or showed a tendency to be higher in close and distant epithelia with any histological grade than in the controls. Parabasal Ki-67 significantly differed between distant epithelia associated with multiple vs single tumours (P < 0.001) and between distant epithelia associated with multiple tumours vs controls (P < 0.001). This difference was not observed between distant epithelia associated with single tumours and controls (P = 0.175). The cut-off point that differentiated epithelia associated with multiple tumours was >50% of Ki-67 + parabasal cells in distant epithelia, which yielded 0.88 sensitivity and 0.79 specificity.
  
  
  CONCLUSIONS
  The concept of a precancerous field may be linked to an increase in the proliferative activity of parabasal cells.
authors.affiliation: Oral Medicine Department, School of Dentistry, University of Granada, Granada, Spain. magonzal@ugr.es
authors.forename: M A
authors.initials: MA
authors.lastname: González-Moles
authors.forename: M
authors.initials: M
authors.lastname: Bravo
authors.forename: I
authors.initials: I
authors.lastname: Ruiz-Avila
authors.forename: F
authors.initials: F
authors.lastname: Acebal
authors.forename: J A
authors.initials: JA
authors.lastname: Gil-Montoya
authors.forename: S
authors.initials: S
authors.lastname: Brener
authors.forename: F
authors.initials: F
authors.lastname: Esteban
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D002294:Carcinoma, Squamous Cell / Q000737:chemistry; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism*; D009062:Mouth Neoplasms / Q000737:chemistry / Q000378:metabolism*; D016609:Neoplasms, Second Primary / Q000737:chemistry / Q000378:metabolism*; D011230:Precancerous Conditions / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen