Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer

Anticancer Res. Nov-Dec 1995;15(6B):2659-68.

Abstract

The prognostic value of Ki-67 expression, ploidy and s-phase fraction was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded surgical specimens of pancreatic ductal adenocarcinomas were stained with a polyclonal Ki-67 antibody. Ploidy and s-phase fraction was assessed by flow cytometry. The median percentage of Ki-67 positive nuclei was 26% (range 0-90%). The level of Ki-67 immunoreactivity was associated with TNM-stage, surgical resectability, tumour grade, ploidy and S-phase fraction. Ninetythree patients, with a nuclear expression of Ki-67 in < 50% of malignant cells, had a median survival of 12.8 months compared with 5.5 months for 25 patients with Ki-67 > or = 50% (p = 0.0008). Ploidy (p < 0.0001) and SPF (p = 0.002) were also significant prognostic factors in a univariate survival analysis. In a multivariate analysis, stage (or alternatively resectability), grade, ploidy and postoperative chemotherapy emerged as independent prognostic factors. When ploidy was excluded from the Cox multivariate model, S-phase fraction also predicted prognosis independently. Ploidy and S-phase fraction are independent prognostic factors in patients with pancreatic cancer. A high level of Ki-67 immunoreactivity is also an indicator of poor prognosis but seems to add little prognostic information to that provided by traditional parameters such as stage, resectability and grade.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / chemistry*
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / mortality*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Aneuploidy*
  • Antigens, Neoplasm / analysis*
  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor / analysis*
  • Cell Division
  • Chemotherapy, Adjuvant
  • DNA, Neoplasm / analysis
  • Finland / epidemiology
  • Humans
  • Ki-67 Antigen
  • Life Tables
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Proteins / analysis*
  • Neoplasm Staging
  • Nuclear Proteins / analysis*
  • Pancreatic Neoplasms / chemistry*
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Prognosis
  • S Phase*
  • Survival Analysis
  • Survival Rate

Substances

  • Antigens, Neoplasm
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Ki-67 Antigen
  • Neoplasm Proteins
  • Nuclear Proteins