Ki-67 proliferation rate as a prognostic marker in major salivary gland carcinomas.
OBJECTIVE
The study was performed to evaluate the prognostic relevance of cell proliferation associated with Ki-67/ Mib-1 immunostaining in malignant tumors of the major salivary glands.


METHODS
Cell proliferation was evaluated by Mib-1 antibody against Ki-67 antigen in 41 patients with cancer of the parotid or submandibular glands, including 14 acinic cell carcinomas, 12 ductal carcinomas, 7 mucoepidermoid carcinomas, 5 carcinomas ex pleomorphic adenoma, 1 adenoid cystic carcinoma, 1 undifferentiated carcinoma, and 1 polymorphous low-grade adenocarcinoma.


RESULTS
Patients with Ki-67 values of more than 15% and those with Ki-67 values of 15% or less differed both in disease-free survival (p < 0.001) and in overall survival (p < 0.001). We evaluated the association between Ki-67 and time to recurrence in correlation to age, sex, ductal histotype, and N stage; the Cox regression model was significant (p = 0.013). In the group of patients with T1 and T2 cancers, those with Ki-67 values of 15% or less had better survival rates than did those with Ki-67 values of more than 15% (p = 0.004). In the group of patients with N0 cancers, those with Ki-67 values of 15% or less had a better survival than did those with Ki-67 values of more than 15% (p < 0.001).


CONCLUSIONS
To our knowledge, this is the first study to stratify different risk classes in early T1-T2 or N0 malignant tumors of the major salivary glands that identified aggressive lesions with elevated Ki-67 expression at an initial stage.
Department of Otolaryngology-Head and Neck Surgery, Maggiore Hospital, Bologna, Italy.
Martino
M
Vacchi-Suzzi
Corso
C
Bocciolini
Claudia
C
Bertarelli
Danilo
D
Dall'Olio
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D018267:Carcinoma, Acinar Cell / Q000401:mortality; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality; D044584:Carcinoma, Ductal / Q000401:mortality; D018277:Carcinoma, Mucoepidermoid / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000401:mortality; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000401:mortality; D013365:Submandibular Gland Neoplasms / Q000401:mortality
D015415:Biomarkers; D019394:Ki-67 Antigen