Prognostic significance of ki-67 labeling index in papillary thyroid carcinoma.
BACKGROUND
Ki-67 is a useful tool for evaluating cell proliferative activity in various tumors. Although the utility of Ki-67 labeling index (LI) to diagnose thyroid neoplasms has been investigated, little is known regarding the relationship between Ki-67 LI and the biological behavior of papillary thyroid carcinoma. In this study, we examined Ki-67 in 371 patients with papillary thyroid carcinoma to elucidate this issue.


METHODS
A total of 371 patients with papillary carcinoma who underwent initial and locally curative surgery between 1996 and 1997 were enrolled in this study. We immunohistochemically investigated Ki-67 LI in their primary lesions and compared this finding with various clinicopathological features, including patient prognosis.


RESULTS
Ki-67 LI was ≤1% in 213 patients (57%) and among the remaining 158, 35 showed Ki-67 LI >3%. Ki-67 LI was associated with patient age, massive extrathyroid extension, and distant metastasis at surgery. Of 363 patients without distant metastasis at surgery, 54 (15%) showed carcinoma recurrence during follow-up (average 124 months) and the disease-free survival (DFS) of patients with Ki-67 LI >1% was significantly worse than that of those with Ki-67 LI <1% (p < 0.0001). On multivariate analysis, Ki-67 LI was recognized as an independent prognostic factor for the DFS of patients. Although only eight patients died of carcinoma in our series, patients with Ki-67 LI >3% showed a significantly worse cause-specific survival (CSS) than those with Ki-67 LI <3% (p < 0.0001).


CONCLUSIONS
Careful evaluation of Ki-67 LI in primary lesions can predict DFS and CSS of patients with papillary thyroid carcinoma.
Ito
Yasuhiro
Y
Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe City, 650-0011, Japan. ito01@kuma-h.or.jp
Miyauchi
Akira
A
Kakudo
Kennichi
K
Hirokawa
Mitsuyoshi
M
Kobayashi
Kaoru
K
Miya
Akihiro
A
D000231:Adenocarcinoma, Papillary / Q000378:metabolism* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000378:metabolism* / Q000401:mortality; D055815:Young Adult
D019394:Ki-67 Antigen