International Cancer Conference Journal

, Volume 6, Issue 2, pp 80–83 | Cite as

Stepwise increase of MIB-1 index in frequently relapsed malignant peritoneal mesothelioma

  • Seiji Isonishi
  • Daito Noguchi
  • Ryosuke Saito
  • Satoshi Yanagida
  • Masaharu Fukunaga
Case report


We identified the stepwise increase of MIB-1 index in a long-surviving malignant peritoneal mesothelioma (MPM) patient with a history of frequent relapse. A 29-year-old Japanese woman showed upper abdominal induration with adnexal tumor. Imaging study with biochemical analyses strongly suggested peritoneal tumor. On primary surgery, all tumors were resected completely without any residual tumor. Histologically, the tumor was diagnosed as MPM, for which she received adjuvant chemotherapy containing platinum agent. Two years later, the tumor relapsed in her pelvic cavity, but was resected completely with hysterectomy and salpingo-oophorectomy. Histologically, the tumor was diagnosed as MPM relapse. She underwent intraperitoneal chemotherapy with cisplatin that achieved progression-free survival of 5 years. However, relapse was detected again in pelvic cavity without any dissemination in upper abdominal cavity. The tumors were completely removed and were revealed to be compatible with MPM. She received gemcitabine and carboplatin chemotherapy. However, 2 years later, the tumor relapsed again in left upper abdominal cavity, for which she wouldn’t receive 4th treatment. To investigate the longevity of this patient in association with the histologic findings, the MIB-1 index was examined in the primary and relapse tumors. The rate of MIB-1 index positive cells was calculated by counting 500 cells. MIB-1 indices were 4.2 ± 1.1 (mean ± SE), 11.8 ± 2.3, and 37.3 ± 2.5 in primary, 1st- and 2nd-relapsed tumor, respectively, demonstrating stepwise increase of MIB-1 expression over the surviving time of more than 9 years. Increase in MIB-1 index was not associated with mitotic index but may be indicating drug sensitivity, resulting in >2-year progression-free interval in each relapse.


Malignant peritoneal mesothelioma Long-term survival Drug sensitivity MIB-1 index 



The authors would like to thank Mr. John Surya of Jikei University School of Medicine for his comments in the preparation of this manuscript.

Compliance with ethical standards

The authors report no conflicts of interest. Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.

Authors have no disclosure of funding received for this work from any of the organizations.


  1. 1.
    Hollen PJ, Gralla RJ, Liepa AM (2004) Adapting the lung cancer symptom scale (LCSS) to mesothelioma using the LCSS-meso conceptual model for validation. Cancer 101:587–595CrossRefPubMedGoogle Scholar
  2. 2.
    Boffetta P (2007) Epidemiology of peritoneal mesothelioma: a review. Ann Oncol 18:985–990CrossRefPubMedGoogle Scholar
  3. 3.
    Marinaccio A, Nesti M, Regional Operating Centers (2003) Analysis of survival of mesothelioma cases in the Italian register (ReNaM). Eur J Cancer 39:1290–1295CrossRefPubMedGoogle Scholar
  4. 4.
    Baratti D, Kusamura S, Domenico CA et al (2012) Cytoreductive surgery with selective versus complete parietal peritonectomy followed by hyperthermic intraperitoneal chemotherapy in patients with diffuse malignant peritoneal mesothelioma: a controlled study. Ann Surg Oncol 19:1416–1424CrossRefPubMedGoogle Scholar
  5. 5.
    Key G, Becker MH, Baron B et al (1993) New Ki-67-equivalent murine monoclonal antibodies (MIB 1–3) generated against bacterially expressed parts of the Ki-67 cDNA containing three 62 base pair repetitive elements encoding for the Ki-67 epitope. Lab Invest 68:629–636PubMedGoogle Scholar
  6. 6.
    Cattoretti G, Becker MH, Key G et al (1992) Monoclonal antibodies against recombinant parts of the Ki-67 antigen (MIB 1 and MIB 3) detect proliferating cells in microwave-processed formalin-fixed paraffin sections. J Pathol 168:357–363CrossRefPubMedGoogle Scholar
  7. 7.
    Geisler JP, Wiemann MC, Miller GA et al (1995) Change in MIB-1 staining between primary and recurrent epithelial ovarian cancer. Eur J Gynaecol Oncol 16:343–345PubMedGoogle Scholar
  8. 8.
    Scholzen T, Gerdes J (2000) The Ki-67 protein: from the known and the unknown. J Cell Physiol 182:311–322CrossRefPubMedGoogle Scholar
  9. 9.
    Spyratos F, Ferrero-Pous M, Trassard M et al (2002) Correlation between MIB-1 and other proliferation markers: clinical implications of the MIB-1 cutoff value. Cancer 15:2151–2159CrossRefGoogle Scholar
  10. 10.
    Hoster E, Rosenwald A, Berger F et al (2016) Prognostic value of Ki-67 index, cytology, and growth pattern in mantle-cell lymphoma: results from randomized trials of the European Mantle Cell Lymphoma Network. J Clin Oncol 34:1386–1395CrossRefPubMedGoogle Scholar
  11. 11.
    Kute TE, Quadri Y, Muss H et al (1995) Flow cytometry in node-positive breast cancer: cancer and leukemia group B protocol 8869. Cytometry 22:297–306CrossRefPubMedGoogle Scholar
  12. 12.
    Simpson JF, Gray R, Dressler LG et al (2000) Prognostic value of histologic grade and proliferative activity in axillary node-positive breast cancer: results from the Eastern Cooperative Oncology Group Companion Study, EST 4189. J Clin Oncol 18:2059–2069CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2017

Authors and Affiliations

  • Seiji Isonishi
    • 1
  • Daito Noguchi
    • 1
  • Ryosuke Saito
    • 1
  • Satoshi Yanagida
    • 1
  • Masaharu Fukunaga
    • 2
  1. 1.Department of Obstetrics and GynecologyJikei Daisan HospitalTokyoJapan
  2. 2.Department of PathologyJikei Daisan HospitalTokyoJapan

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