Journal of Surgery

Ki 67 as Prognostic Factor in Surgically Resected Pancreatic Ductal Adenocarcinoma

Abstract

Florina-Delia Andriesi-Rusu, Ana-Maria Trofin, Irene Cianga-Spiridon, Nutu Vlad, Alin Vasilescu, Eugen Târcoveanu and Cristian Lupașcu

Background: Pancreatic ductal adenocarcinoma is one of the most aggressive neoplasms, with a poor prognostic and overall survival, most of the patients (over 80%) being diagnosed in advanced stages of the disease, either with distant metastasis or with the locally unresectable tumor. The Ki-67 antigen is a nuclear antigen expressed in all cellular phases (except for the G0 phase) and a high Ki-67 index can be correlated with a recurrence rate of tumor and survival.
Aim: The aim of our study was to demonstrate if the Ki-67 index can be used as a negative prognostic factor for survival.
Methods: We reviewed retrospectively all patients with pancreatic ductal adenocarcinoma (confirmed histologically) and were selected only those with resectable tumors (19.5%). For these patients, immunoreactivity for Ki-67 was evaluated according to the percentage of positive tumor nuclei. The survival was calculated from the data of surgery to a patient’s death.
Results: 19.5% of patients were diagnosed with surgically resectable tumors, with a mean tumor’s size of 3.3 cm. The overall survival rate at 2 years was 21.15%. The patients with a Ki-67 index over 80% had a significantly lower average survival than the other patients.
Conclusions: The immunohistochemistry staining for Ki-67 can be applied as a prognostic marker for survival in resectable ductal pancreatic adenocarcinoma.