title: The clinical utility of Ki-67 in assessing tumor biology and aggressiveness in patients with appendiceal carcinoids.
abstract: OBJECTIVE
  To elucidate the correlation of Ki-67 with tumor biology and survival in appendiceal carcinoid tumors.
  
  
  METHODS
  A retrospective chart review conducted on 51 patients with appendiceal carcinoid tumors who underwent surgical intervention from 1991 to 2008. MIB-1, an antibody of Ki-67, was used to determine cell proliferation and correlated with clinical and histological parameters. MIB-1 index was categorized according to the World Health Organization (WHO) classification.
  
  
  RESULTS
  Of the 51 patients, 32 had tumors <2 cm; 3 >2 cm; and 16 with unspecified tumor size. Increased MIB proliferative index did not significantly correlate with increasing tumor size (P = 0.426). Twelve patients had metastatic disease on presentation: 9 had MIB-1 index <2%, 1 had index 2-15% and 2 with index >15%. No significant correlation between MIB index and metastasis was demonstrated (P = 0.68). Median follow-up was 40 months (range 10-183 months) with a 51% follow-up rate. Seven mortalities and three recurrences presented in 26 patients. Assessment of survival demonstrated significantly decreased survival by increasing MIB index. Survival rate by MIB index was as follows: <2% was 97%, 2-15% was 85% and >15% was 67% (P = 0.02).
  
  
  CONCLUSIONS
  Increased MIB index significantly correlated with decreased survival. No correlation was demonstrated by MIB index and tumor size or presentation with metastatic disease.
authors.affiliation: Division of General Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Liu
authors.forename: Dana A
authors.initials: DA
authors.lastname: Telem
authors.forename: John
authors.initials: J
authors.lastname: Hwang
authors.forename: Richard R P
authors.initials: RR
authors.lastname: Warner
authors.forename: Andrew
authors.initials: A
authors.lastname: Dikman
authors.forename: Celia M
authors.initials: CM
authors.lastname: Divino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001063:Appendiceal Neoplasms / Q000401:mortality / Q000473:pathology*; D002276:Carcinoid Tumor / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness
chemical_list: D019394:Ki-67 Antigen