Ki-67 immuno-histochemistry index in stage III giant cell tumor of the bone

Abstract

BackgroundGiant cell tumor is an infrequent and unpredictable bony lesion. Although numerous attempts have been made to predict the behaviour of GCT, there are no definite biological or histological parameters to determine the prognosis or aggressiveness of this lesionMaterials and methodsWe analyzed Ki 67 immuno-histochemistry of 31 consecutive cases staged III giant cell tumor to determine the clinico-pathological correlation. There were 19 male patients compare to 12 females. The mean age was 33.8 years ranged from 18 to 59 years. Five cases presented with local recurrence prior to wide resection and one case had multiple recurrences there after. Six cases had pulmonary metastases. Expression of Ki 67 antigen was evaluated by immuno-histochemical staining techniques using the avidin-biotin perioxidase complex method using an LSAB2 kit (Dako, Glostrup, Denmark). The primary antibody used in this study was Ki-67 (MIB-I clone, dilution 1:25; Dako).ResultsThe mean value of Ki-67 index obtained as a percentage of 1000 background cells was 8.15 (ranged 1.00 - 20.0). The median Ki 67 index was 7.5 with standard deviation of 5.12. The Ki 67 index of recurrence tumor was 4.323 compared to 6.05 without recurrence and was not statistically significant (mean difference of 0.865 with p value in independent t test of 0.736). The Ki 67 index was also not statistically significant in the presence of pulmonary metastases with the mean value of metastases group of 6.681 compared to 2.890 without metastases (mean difference of 1.895 with p value in independent t test of 0.424).ConclusionKi 67 index is not use-full prognostic marker for aggressive type of giant cell tumor of the bone.

Prognostic value of p53 protein expression in giant cell tumor of bone

“…Furthermore, several studies report that the Ki-67 index in recurrent cases is higher than in the primary tumor, and some studies report that there is no difference between the primary tumor and the recurrent tumor [16,26,27]. Ismail et al emphasized that Ki-67 is not a useful immunopathological marker in predicting local recurrence and lung metastasis of GCTB [25]. We did not find a statistically significant relationship between the Ki-67 index and local recurrence and lung metastasis.…”

“…The percentage of cells expressing cellular staining with the immunohistochemical stain for Ki-67 gives the proliferative index. The index is usually high in aggressive tumors and is regarded as a poor prognostic factor [25,26,27]. In our series, giant cells were Ki-67-negative in all cases and mononuclear cells were Ki-67-positive in various proportions of tumor cells.…”

“…Many studies have been performed to identify the prognostic markers in biopsies to predict clinical behavior. The Campanacci staging system, Ki-67 proliferative index, and p53 positivity are among the most popular prognostic markers [9,16,24,25]. Ki-67 is a nuclear protein found in proliferating cells.…”

Symplastic/pseudoanaplastic giant cell tumor of the bone

“…These studies showed that the proliferation index, as shown by Ki-67, is low in these lesions, with no indication that positive staining of Ki-67 was present in the pseudoanaplastic cells. Proliferative index using Ki-67 immunostain has been studied in conventional GCTB with a reported range between 1 and 20 % [20, 21]. In the study by Ismail et al, no correlation was found between Ki-67 proliferative index and biological behavior (recurrence and metastasis) [20].…”

“…Proliferative index using Ki-67 immunostain has been studied in conventional GCTB with a reported range between 1 and 20 % [20, 21]. In the study by Ismail et al, no correlation was found between Ki-67 proliferative index and biological behavior (recurrence and metastasis) [20]. All of our 9 cases had low Ki-67 labeling (0–10 %) and Ki-67 staining was essentially negative or only seen in rare atypical stromal cells.…”