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Ki‐67 immunolabelling index is a prognostic indicator in childhood posterior fossa ependymomas
Author(s) -
Luke Bennetto,
Nicholas Foreman,
Brian Harding,
Richard Hayward,
James W. Ironside,
Seth Love,
David W. Ellison
Publication year - 1998
Publication title -
neuropathology and applied neurobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.538
H-Index - 95
eISSN - 1365-2990
pISSN - 0305-1846
DOI - 10.1046/j.1365-2990.1998.00143.x
Subject(s) - ependymoma , ki 67 , medicine , pathology , population , adjuvant therapy , univariate analysis , proportional hazards model , posterior fossa , multivariate analysis , immunohistochemistry , radiology , cancer , environmental health
Conventional histological evaluation and subclassification of childhood ependymomas poorly predict their biological behaviour. The Ki‐67 labelling index (Ki‐67 LI), a measure of growth fraction, correlates with the biological behaviour of several neoplasms, and this retrospective study tested the hypothesis that Ki‐67 LI is a prognostic indicator in childhood posterior fossa ependymomas. Immunocytochemistry using an antibody to Ki‐67 was undertaken on 5 μm sections of formalin‐fixed, paraffin‐embedded tissue from 74 cases of childhood (age <16 years.) posterior fossa ependymoma. A Ki‐67 LI was established by counting the proportion of labelled nuclei in more than 1000 cells from several histological fields. Several clinical and histological variables (including Ki‐67 LI) potentially associated with survival were entered into univariate and multivariate analyses using a Cox proportional hazards model.Variables that showed a significant and independent association with survival were Ki‐67 LI ( P <0.002), whether total surgical resection had been achieved according to operation records ( P <0.03), and whether no adjuvant therapy had been given ( P <0.01). Age, sex, and the presence of necrosis or microvascular proliferation did not correlate with survival. In our defined population of patients with ependymomas, Ki‐67 LI is a strong prognostic indicator. We recommend that Ki‐67 LI is used in the histological evaluation of childhood posterior fossa ependymomas during trials of novel adjunctive therapies.