Proliferative activity (MIB-1 index) is an independent prognostic parameter in patients with high-grade soft tissue sarcomas of subtypes other than malignant fibrous histiocytomas: a retrospective immunohistological study including 216 soft tissue sarcomas

Histopathology. 1998 Jun;32(6):536-46.


Aims: To evaluate the prognostic value of tumour proliferative activity, p53 accumulation and bcl-2 expression in a retrospective series of 216 patients with soft tissue sarcomas (STS).

Methods and results: The immunohistochemical analyses were performed on formalin-fixed, paraffin-embedded tissue. The proliferative activity was assessed by use of the monoclonal antibody MIB-1 and evaluated in multiple, random systematic sampled fields of vision. The percentage of proliferating cells (the MIB-1 index) ranged between 1% and 85% (median 12%). A significant increase in mean MIB-1 index was seen with increasing histological malignancy grade. Variation in the incidence of p53 accumulation and bcl-2 positivity among different histological subtypes was observed. p53 accumulation was frequent in synovial sarcomas and leiomyo- and rhabdomyosarcomas, whereas bcl-2 preferentially was expressed in synovial sarcomas. Univariate analysis identified patient age, tumour size, histological grade of malignancy, MIB-1 index and p53 accumulation as significant prognostic parameters. Multivariate Cox analysis, including tests for interaction terms between histological subtypes and MIB-1 index, showed independent prognostic effect of MIB-1 index and tumour size in patients with high-grade tumours of other subtypes than malignant fibrous histiocytoma (MFH).

Conclusions: Histopathological malignancy grading is the most important single prognostic factor for overall survival in STS, but estimation of MIB-1 index is useful for identifying the least favourable subgroup of high grade STS of other subtypes than MFH, for whom adjuvant therapy may be indicated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Nuclear
  • Cell Division
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Infant
  • Ki-67 Antigen
  • Middle Aged
  • Nuclear Proteins / analysis
  • Prognosis
  • Proto-Oncogene Proteins c-bcl-2 / analysis
  • Retrospective Studies
  • Sarcoma / chemistry
  • Sarcoma / diagnosis
  • Sarcoma / mortality
  • Sarcoma / pathology*
  • Soft Tissue Neoplasms / chemistry
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology*
  • Survival Rate
  • Tumor Suppressor Protein p53 / analysis


  • Antigens, Nuclear
  • Ki-67 Antigen
  • Nuclear Proteins
  • Proto-Oncogene Proteins c-bcl-2
  • Tumor Suppressor Protein p53