Department of HPB Surgery, Methodist Dallas Medical Center, Dallas, Texas 75208, USA.
J Surg Oncol. 2012 Nov;106(6):724-7. doi: 10.1002/jso.23124. Epub 2012 May 1.
The Ki-67 index has been incorporated into The World Health Organization's classification system of pancreatic neuroendocrine tumors. However, pathologists continue to question the utility of Ki-67 index over that of mitotic count as an indicator of proliferative activity. The intent of the current study is to compare K-i67 index with tumor size and mitotic rate for the association of each with lymph node metastasis and survival.
The current study is a review of 24 patients with pancreatic neuroendocrine tumors.
Regional LNM were present in 100% of tumors with Ki-67 index >10%, while only 25% of tumors with <10% Ki-67 had LNM (P = 0.003). No tumors <2 cm had >10% Ki-67 labeling. Of patients with tumors showing ≥ 10% Ki-67 labeling, 80% died during the observation period of this study, while during the same time period, no patients with <10% Ki-67 labeling died.
Ki-67 index of >10% is a sensitive indicator of malignant behavior and mortality. Future advances in management of pNETs will require development of staging guidelines with higher predictive value. Inclusion of Ki-67 labeling >10% as an indicator of aggressive disease may contribute to such improvements.
Ki-67 指数已被纳入世界卫生组织的胰腺神经内分泌肿瘤分类系统。然而，病理学家仍然质疑 Ki-67 指数作为增殖活性指标的效用是否超过有丝分裂计数。本研究的目的是比较 Ki-67 指数与肿瘤大小和有丝分裂率，以评估它们与淋巴结转移和生存的关系。
本研究回顾性分析了 24 例胰腺神经内分泌肿瘤患者。
Ki-67 指数>10%的肿瘤中存在区域淋巴结转移（LNM）的比例为 100%，而 Ki-67 指数<10%的肿瘤中 LNM 的比例仅为 25%（P=0.003）。Ki-67 指数<2cm 的肿瘤无一例出现>10%的阳性标记。Ki-67 指数≥10%的患者中，80%在本研究的观察期间死亡，而 Ki-67 指数<10%的患者在此期间无死亡。
Ki-67 指数>10%是恶性行为和死亡率的敏感指标。未来，pNETs 的管理进展将需要制定具有更高预测价值的分期指南。将 Ki-67 指数>10%作为侵袭性疾病的指标可能有助于这些进展。
