Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada.
Department of Otolaryngology-Head and Neck Surgery, McGill University, Royal Victoria Hospital, Montreal, QC H4A 3J1, Canada.
Curr Oncol. 2024 Jul 17;31(7):4030-4037. doi: 10.3390/curroncol31070300.
Ki-67 immunostaining is commonly used in neuroendocrine tumors to estimate the proliferative index and for grading. This study investigates its association with the invasiveness of follicular-derived thyroid carcinomas (TCs).
A retrospective analysis of patients with TC at three McGill University teaching hospitals between January 2018 and November 2023 was conducted. The inclusion criteria included patients with malignant thyroid tumors and accessible Ki-67 LI data from final pathology specimens. The data collected included patient demographics, Ki-67 LI values, and different invasiveness attributes, such as molecular mutations, the histological subtype, lymphovascular invasion (LVI), extrathyroidal extension (ETE), and positive lymph nodes (LNs).
In total, 212 patients met the inclusion criteria, of which 80.7% were females and 19.3% were males. The Ki-67 LI ranged from 1% to 30%, with the majority of the cases within the range of 1-15%. A significant association was observed between higher Ki-67 LI and high-risk histological subtypes of thyroid carcinoma ( < 0.001). Similarly, Ki-67 LI was significantly associated with LVI and positive LN metastasis ( < 0.001 and = 0.036, respectively). However, no significant association was found between the Ki-67 LI and gene mutations or ETE ( = 0.133 and = 0.190, respectively). Using percentiles to establish a cutoff, patients with a Ki-67 LI higher than 6.7 showed a higher likelihood of being associated with invasive features.
Elevated Ki-67 LI can serve as an indicator of aggressiveness in follicular-derived TC, especially when associated with distinct histological subtypes, LVI and positive LNs.
Ki-67 免疫组化常用于神经内分泌肿瘤，以评估增殖指数并进行分级。本研究探讨了其与滤泡源性甲状腺癌（TC）侵袭性的关系。
对 2018 年 1 月至 2023 年 11 月在麦吉尔大学三家教学医院就诊的 TC 患者进行了回顾性分析。纳入标准包括恶性甲状腺肿瘤患者和最终病理标本中可获得 Ki-67 LI 数据。收集的数据包括患者的人口统计学特征、Ki-67 LI 值以及不同侵袭性特征，如分子突变、组织学亚型、血管淋巴管侵犯（LVI）、甲状腺外侵犯（ETE）和阳性淋巴结（LNs）。
共有 212 名患者符合纳入标准，其中 80.7%为女性，19.3%为男性。Ki-67 LI 范围为 1%至 30%，多数病例在 1%至 15%范围内。高 Ki-67 LI 与高危甲状腺癌组织学亚型显著相关（<0.001）。同样，Ki-67 LI 与 LVI 和阳性 LN 转移显著相关（<0.001 和=0.036，分别）。然而，Ki-67 LI 与基因突变或 ETE 之间无显著相关性（=0.133 和=0.190，分别）。使用百分位数建立截断值，Ki-67 LI 高于 6.7%的患者更有可能与侵袭性特征相关。
Ki-67 LI 升高可作为滤泡源性 TC 侵袭性的指标，尤其是与特定的组织学亚型、LVI 和阳性 LN 相关时。
