title: Ki67 Overexpression in mucosa distant from oral carcinoma: A poor prognostic factor in patients with long-term follow-up.
abstract: OBJECTIVE
  The aggressive behavior of oral squamous cell carcinoma (OSCC) has recently been related to the mucosa surrounding the primary mass, consisting of genetically altered cells that might be responsible for cancer progression. The aim of the study was to determine whether an abnormal cell turnover in clinically and histologically "normal" mucosa distant from the primary tumor is associated with a poor prognosis in terms of locoregional control (LRC) of disease and disease-specific survival (DSS).
  
  
  METHODS
  This prospective study monitored 55 OSCC patients. Cell turnover in areas clinically and histologically distant from the tumor mass was evaluated by immunohistochemical expression of Ki67. A Ki67 value >20% was considered "high."
  
  
  RESULTS
  The mean follow-up period of the population studied was 53.7 ± 32.4 months (range 12-110 months). Multivariate analysis showed that the Ki67 value in distant mucosa was a powerful independent prognostic factor for LRC. In addition, high Ki67 expression in distant mucosa was the only variable statistically related to worse LRC (χ(2) = 9.5; p = 0.002) and DSS (χ(2) = 5.51; p = 0.02) in T1-2N0 OSCCs.
  
  
  CONCLUSIONS
  The present study confirmed the role of Ki67 in tumor-distant areas as a prognostic marker for OSCC patients.
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. L. Montebugnoli), Section of Oral Sciences, University of Bologna, Italy. Electronic address: davide.gissi@unibo.it.
authors.forename: Davide Bartolomeo
authors.initials: DB
authors.lastname: Gissi
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. L. Montebugnoli), Section of Oral Sciences, University of Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gabusi
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. C. Marchetti), University of Bologna, Section of Maxillo-facial Surgery at Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Achille
authors.initials: A
authors.lastname: Tarsitano
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. C. Marchetti), University of Bologna, Section of Maxillo-facial Surgery at Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Badiali
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. C. Marchetti), University of Bologna, Section of Maxillo-facial Surgery at Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Marchetti
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. M. P. Foschini), Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Morandi
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. M. P. Foschini), Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Foschini
authors.affiliation: Department of Biomedical and Neuromotor Sciences (Head: Prof. L. Montebugnoli), Section of Oral Sciences, University of Bologna, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Montebugnoli
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism* / Q000473:pathology; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D019394:Ki-67 Antigen
keywords: Distant mucosa; Field cancerization; Immunohistochemistry; Ki67; Oral squamous cell carcinoma; Prognosis