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Ki‐67 immunostaining and other prognostic factors including tobacco smoking in patients with resected nonsmall cell lung carcinoma
Author(s) -
Shiba Mitsutoshi,
Kohno Hiromasa,
Kakizawa Kimitaka,
Iizasa Toshihiko,
Otsuji Mizuto,
Saitoh Yukio,
Hiroshima Kenzo,
Ohwada Hidemi,
Fujisawa Takehiko
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20001001)89:7<1457::aid-cncr7>3.0.co;2-l
Subject(s) - medicine , ki 67 , immunostaining , lung cancer , oncology , stage (stratigraphy) , carcinoma , adenocarcinoma , survival rate , gastroenterology , lymph node , cancer , pathology , immunohistochemistry , paleontology , biology
Abstract BACKGROUND To estimate the effectiveness of expression of the tumor proliferative marker Ki‐67 antigen (Ki‐67) as a postoperative prognostic marker, the authors analyzed Ki‐67 expression and its correlation with postoperative survival and other clinicopathologic factors, including preoperative smoking habits, in patients with resected nonsmall cell lung carcinoma (NSCLC). METHODS A total of 156 patients with resected NSCLC at the study institution were investigated. Postoperative survival rates were estimated based on demographic and clinicopathologic factors, including Ki‐67 expression and preoperative tobacco smoking habits. RESULTS The overall postoperative 5‐year survival rate in patients with high Ki‐67 labeling indices (≥ 20%) was 39.6% compared with 67.7% in patients with low Ki‐67 labeling indices. This finding was significant for all resected cases and for each pathologic disease stage ( P < 0.05). The postoperative 5‐year survival rate in patients with a history of heavy smoking (≥ 30 pack‐years) was 47.6% compared with 62.5% for other patients ( P = 0.027). This result was especially significant in patients with International Union Against Cancer Stage I disease and in patients with nonsquamous cell carcinoma ( P < 0.03). The authors also observed a positive correlation between the Ki‐67 labeling index and preoperative smoking habits ( P = 0.0002). Multivariate analysis demonstrated that lymph node involvement, tumor differentiation, and Ki‐67 labeling index were significant prognostic factors in NSCLC ( P < 0.01). CONCLUSIONS Tumor Ki‐67 expression is a strong prognostic factor in NSCLC, especially adenocarcinoma. It may be hypothesized that tobacco mutagenicity may play a role in the growth and extension of NSCLC, which is one of the major impediments to postoperative survival in patients with a history of heavy smoking. Cancer 2000;89:1457–65. © 2000 American Cancer Society.