title: Expression of Ki-67 as proliferation biomarker in imprint smears of endometrial carcinoma.
abstract: The aims of this study were to determine the expression of Ki-67 in type I and type II endometrial adenocarcinomas as well as normal endometrium in imprint smears and to correlate the results with clinicopathologic parameters of primary untreated endometrial cancer patients. During a 29-month period, 255 patients were evaluated with entometrial imprint cytology. Endometrial samples freshly resected from women who underwent total abdominal hysterectomy were studied. One hundred twenty-six patients had endometrial carcinoma and 129 cases were diagnosed as normal endometrium. The expression of Ki-67 was assessed by immunocytochemistry. Positive staining was correlated with increased stage, grade and lymph node metastases. High expression was more frequent in type II than type I endometrial adenocarcinoma and high-grade endometrial carcinoma had higher proportions of Ki-67 positive immunostaining compared with low-grade carcinoma. Proliferative endometrium showed high Ki-67 expression level, even higher than those of grade 1 and type I. On the other hand, secretory endometrium Ki-67 positive cells were markedly diminished and even disappeared. Completely negative staining was found to be related to atrophic endometrium. Immunocytochemical findings from Ki-67 stain, in addition to cytomorphologic features, appeared to be useful for the diagnosis of endometrial carcinoma in endometrial cytology with imprint smears. High Ki-67 expression correlates with morphologic features of aggressiveness and the expression pattern of Ki-67 correspond to the expected cyclic/atrophic pattern in normal endometrium.
authors.affiliation: Department of Cytopathology, Anti-cancer Oncological Hospital St. Savvas, Athens, Greece. kosmas_konstantinos@yahoo.gr
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kosmas
authors.forename: Marios
authors.initials: M
authors.lastname: Stamoulas
authors.forename: Anna
authors.initials: A
authors.lastname: Marouga
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Kavantzas
authors.forename: Efstratios
authors.initials: E
authors.lastname: Patsouris
authors.forename: Paulina
authors.initials: P
authors.lastname: Athanassiadou
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D049109:Cell Proliferation; D003581:Cytodiagnosis / Q000379:methods*; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004717:Endometrium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D019394:Ki-67 Antigen / Q000378:metabolism*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D013048:Specimen Handling
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen