Proliferative Activity (Ki-67 Expression) and Outcome in High GradeOsteosarcoma: A Study of 27 Cases

[摘要] Purpose.Although pre-operative chemotherapy has improved theprognosis for individuals with osteosarcoma, approximately 40% of patients will die of theirdisease.The aim of this study was to quantitate proliferative activity in high gradeosteosarcomas and to determine whether proliferation is a prognostic factor.Patients.The study consisted of 27 patients with high gradenon-metastatic osteosarcoma at various sites for whom pre-operative biopsies andresection specimens were available for review. All patients were treated similarly andhad at least 24 months' follow-up from the date of diagnosis.Methods.Proliferative activity (Ki-67 expression) was examined in thediagnostic biopsies immunohistochemically using the MIB-1 antibody. Proliferation wasquantitated in two ways; (1) the number of immunopositive cells was counted manually using an ocular grid; or (2) the percentage of immunopositive nuclear area was assessed using morphometric image analysis. Proliferative index was evaluated in relation to patient outcome.Results.Proliferative activity was seen in all biopsies.The median proliferative index as determined by counting cells was 24% (mean of 27%, range of 7–61%) and by image analysis was 2% (mean 3%, range 0.32–8.4).The correlation betweenMIB-1 proliferation indices determined either by image analysis methodology or manual cellcounting was high (Spearman's rho=0.79). Proliferative index did not appear to predict eitherdisease-free or overall survival.Discussion.Tumor proliferation does not appear to be prognostic forhigh grade osteosarcomas.Whether assessment of this feature in conjunction with othertumor characteristics might be prognostic requires further study.

[学科分类] 肿瘤学