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Prognostic Significance of Ki-67 Labeling Index in Papillary Thyroid Carcinoma

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Abstract

Background

Ki-67 is a useful tool for evaluating cell proliferative activity in various tumors. Although the utility of Ki-67 labeling index (LI) to diagnose thyroid neoplasms has been investigated, little is known regarding the relationship between Ki-67 LI and the biological behavior of papillary thyroid carcinoma. In this study, we examined Ki-67 in 371 patients with papillary thyroid carcinoma to elucidate this issue.

Methods

A total of 371 patients with papillary carcinoma who underwent initial and locally curative surgery between 1996 and 1997 were enrolled in this study. We immunohistochemically investigated Ki-67 LI in their primary lesions and compared this finding with various clinicopathological features, including patient prognosis.

Results

Ki-67 LI was ≤1% in 213 patients (57%) and among the remaining 158, 35 showed Ki-67 LI >3%. Ki-67 LI was associated with patient age, massive extrathyroid extension, and distant metastasis at surgery. Of 363 patients without distant metastasis at surgery, 54 (15%) showed carcinoma recurrence during follow-up (average 124 months) and the disease-free survival (DFS) of patients with Ki-67 LI >1% was significantly worse than that of those with Ki-67 LI <1% (p < 0.0001). On multivariate analysis, Ki-67 LI was recognized as an independent prognostic factor for the DFS of patients. Although only eight patients died of carcinoma in our series, patients with Ki-67 LI >3% showed a significantly worse cause-specific survival (CSS) than those with Ki-67 LI <3% (p < 0.0001).

Conclusions

Careful evaluation of Ki-67 LI in primary lesions can predict DFS and CSS of patients with papillary thyroid carcinoma.

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Authors and Affiliations

  1. Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe City, 650-0011, Japan

    Yasuhiro Ito, Akira Miyauchi, Kaoru Kobayashi & Akihiro Miya

  2. Department of Pathology, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe City, 650-0011, Japan

    Mitsuyoshi Hirokawa

  3. Department of Pathology, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, 641-8509, Japan

    Kennichi Kakudo

Authors
  1. Yasuhiro Ito
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  2. Akira Miyauchi
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  3. Kennichi Kakudo
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  4. Mitsuyoshi Hirokawa
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  5. Kaoru Kobayashi
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  6. Akihiro Miya
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Correspondence to Yasuhiro Ito.

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Ito, Y., Miyauchi, A., Kakudo, K. et al. Prognostic Significance of Ki-67 Labeling Index in Papillary Thyroid Carcinoma. World J Surg 34, 3015–3021 (2010). https://doi.org/10.1007/s00268-010-0746-3

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