title: Evaluation of epithelial proliferation in paediatric and adult cholesteatomas using the Ki-67 proliferation marker.
abstract: BACKGROUND
  The aggressiveness of cholesteatoma in children compared with adults is well known. However, the factors influencing the poorer prognosis of paediatric cholesteatoma are not well understood. This study compared the proliferative potential of paediatric cholesteatoma with that of adult cholesteatoma, using Ki-67 as a proliferation marker.
  
  
  METHODS
  A prospective study of 67 patients with aural cholesteatoma was performed. Thirty-eight adult and 29 paediatric cases were evaluated using clinical parameters including bone erosion, complications and extent of disease. A surgical specimen underwent histological evaluation and measurement of the proliferation index using Ki-67 labelling. Normal epithelium from a control group was also examined.
  
  
  RESULTS
  Cholesteatoma epithelium has a greater rate of proliferation than normal skin. There were however no statistical differences between the paediatric and adult cholesteatoma groups in terms of clinical behaviour or proliferation potential. Paediatric cholesteatoma was similar to adult cholesteatoma in terms of complications, bone erosion and disease spread.
  
  
  CONCLUSIONS
  Cholesteatoma is a disorder of epithelial proliferation. Although postulated to be more aggressive in children than adults, this study found no clinicopathological differences between paediatric and adult cases.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: K
authors.initials: K
authors.lastname: Sikka
authors.forename: S C
authors.initials: SC
authors.lastname: Sharma
authors.forename: A
authors.initials: A
authors.lastname: Thakar
authors.forename: S
authors.initials: S
authors.lastname: Dattagupta
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D049109:Cell Proliferation; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004848:Epithelium / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013194:Staining and Labeling; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen