title: Expression of the proliferation marker Ki-67 associates with tumour staging and clinical outcome in differentiated thyroid carcinomas.
abstract: OBJECTIVE
  Although the prognosis of differentiated thyroid carcinoma (DTC) is excellent, with 10-year survival rates of about 90%, about one-third of patients experiences recurrent disease. We aimed to identify novel histological prognostic factors to optimize treatment and follow-up of patients at risks.
  
  
  METHODS
  Retrospective analysis of patients diagnosed from January 1990 to March 2004.
  
  
  METHODS
  A total of 93 patients diagnosed with DTC of which 67 with papillary and 26 with follicular histology.
  
  
  METHODS
  Analysis of immunohistochemical expression of somatostatin receptor (sst) subtypes 1-5, glucose transporter-1 (GLUT-1), receptor tyrosine kinase c-KIT, oestrogen and progesterone receptors, and proliferation marker Ki-67 and correlation with the patients' clinical outcome.
  
  
  RESULTS
  DTC showed immunohistochemical expression of GLUT-1, C-KIT and progesterone receptor in a high percentage of cases (range: 57-80%). In contrast, the oestrogen receptor as well as the sst subtypes 1-5 was less frequently detected (range: 15-29%). Mean staining of the proliferation marker Ki-67 was 6% positive cells (range 0-20%). Ki-67 expression was significantly associated with tumour staging (ρ = 0·2076, P = 0·0459), whereas the other histopathological markers were not associated with gender, age, tumour entity, or tumour classification. Tumour staging and expression of Ki-67, oestrogen receptor and sst2, but of none of the other histopathological factors, independently predicted the clinical outcome 5 years after definitive treatment (P < 0·0001, P < 0·0001, P = 0·0004 and P = 0·0206, respectively).
  
  
  CONCLUSIONS
  In patients with DTC, Ki-67 expression associates with tumour staging and clinical outcome.
authors.affiliation: Division of Endocrinology, Diabetes, Angiology, Nephrology and Clinical Chemistry, Department of Internal Medicine, University Hospital of Tübingen, Tübingen, Germany. muessig@kaiserswerther-diakonie.de
authors.forename: Karsten
authors.initials: K
authors.lastname: Müssig
authors.forename: Tobias
authors.initials: T
authors.lastname: Wehrmann
authors.forename: Helmut
authors.initials: H
authors.lastname: Dittmann
authors.forename: Manfred
authors.initials: M
authors.lastname: Wehrmann
authors.forename: Bianca
authors.initials: B
authors.lastname: Ueberberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Schulz
authors.forename: Roland
authors.initials: R
authors.lastname: Bares
authors.forename: Stephan
authors.initials: S
authors.lastname: Petersenn
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D002454:Cell Differentiation; D049109:Cell Proliferation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen