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Expression profiling using tissue microarray in 211 malignant fibrous histiocytomas confirms the prognostic value of Ki-67

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Abstract

The tissue microarray technology is a high-throughput technique that allows studies of multiple markers in large tumor materials. We performed immunohistochemical profiling using tissue microarray and immunostaining for Ki-67, p53, bcl-2, CD44, cyclin A and Pgp in a series of 211 malignant fibrous histiocytomas (MFHs) with correlation to prognosis. Tissue from 50 local recurrences and 20 metastases was available for comparison with the primary tumors. In univariate analysis, Ki-67 was the only immunohistochemical marker significantly correlated with metastasis with a hazard ratio of 1.9. Multivariate analysis, with tumor size, depth, necrosis, vascular invasion, mitotic rate and Ki-67 expression, revealed an independent prognostic value of tumor size and Ki-67. Local recurrences did not differ from the corresponding primary tumors, whereas metastases showed a trend for upregulation of cyclin A and Pgp. In this large series of MFHs, a tumor size greater than 8 cm and a Ki-67 index of more than 20% were strong and independent prognostic factors for metastasis. In contrast, p53, bcl-2, CD44, cyclin A and Pgp, which have previously been suggested as prognostic factors in soft tissue sarcomas, did not show such correlations. Hence, we suggest that proliferation, as measured by Ki-67 index, should be considered as a prognostic marker in clinical management of pleomorphic soft tissue sarcomas.

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Acknowledgements

We would like to acknowledge the work performed by the SSG Pathology review committee, which apart from the authors consist of: Lars-Gunnar Kindblom1, Tom Böhling2, Tore B. Halvorsen3, and Helena Willén4. (1Sahlgrenska University Hospital, Gothenburg, Sweden, 2University of Helsinki, Helsinki, Finland, 3St Olavs Hospital, Trondheim, Norway, 4Uppsala University Hospital, Uppsala, Sweden). Evy Nilsson at the SSG office is acknowledged for efficient help administrating tissue blocks and with clinical data. The study was financially supported by the Swedish Cancer Society, the Children’s Cancer Foundation, the G. Nilsson Cancer Foundation, the B. Kamprad Cancer Foundation and the Lund University Hospital Fund.

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Authors and Affiliations

  1. Department of Oncology, Jubileum Institution, Lund University, 221 85 , Lund, Sweden

    Jacob Engellau, Pär-Ola Bendahl, Thor A. Alvegård & Mef Nilbert

  2. Department of Pathology and Cytology, Lund University Hospital, 221 85 , Lund, Sweden

    Annette Persson, Måns Åkerman & Henryk A. Domanski

  3. Department of Orthopedics, Lund University Hospital, 221 85 , Lund, Sweden

    Anders Rydholm

  4. Department of Pathology, Norwegian Radium Hospital, 0310 , Oslo, Norway

    Bodil Bjerkehagen

  5. Department of Pathology, Haukeland University Hospital, 5021 , Bergen, Norway

    Peer Lilleng

  6. Department of Pathology, Karolinska University Hospital, 171 76 , Stockholm, Sweden

    Johan Weide

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  1. Jacob Engellau
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Correspondence to Jacob Engellau.

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Engellau, J., Persson, A., Bendahl, PO. et al. Expression profiling using tissue microarray in 211 malignant fibrous histiocytomas confirms the prognostic value of Ki-67. Virchows Arch 445, 224–230 (2004). https://doi.org/10.1007/s00428-004-1065-6

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  • DOI: https://doi.org/10.1007/s00428-004-1065-6

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