Assessment of the proliferation index in gastric carcinomas with the monoclonal antibody MIB 1

Abstract

Our study aimed to reveal whether the proliferation index of tumor cells, calculated with the monoclonal antibody (mAb) MIB1, is of prognostic relevance in patients with a gastric carcinoma and shows any correlation to well-known clinicopathological factors (TNM categories, stage, grade, Laurén type). We examined formalin-fixed, paraffin-embedded tissue blocks of samples from 94 patients, who underwent surgery for an adenocarcinoma of the stomach between 1988 and 1991. Specimens were immunohistochemically stained using the mAb MIB1 in combination with the alkaline-phosphatase/anti-(alkaline phosphatase) technique. The proliferation index (PI) was estimated in various areas of interest (tumor center and periphery and in lymph node metastases of compartments I and II), by always counting 200 tumor cells in three different high-power fields per specimen, and calculated as the percentage of MIB1-positive tumor cell nuclei relative to all tumor cell nuclei in the area examined. The total PI in the primary tumor was 47.2% and slightly higher in the center (49.1%) compared to the periphery (44.7%). Surprisingly in lymph node metastases the PI was lower than in the primary tumor (compartment I: 39.5%, compartment II: 33.6%). Tumors with distant metastases revealed a higher proliferative activity (55.1%) than tumors without (44.3%). The PI increased significantly from well to poorly differentiated carcinomas (P < 0.01), whereas the intestinal Laurén type showed a lower PI than the diffuse type. No difference in survival was found between patients with a median PI or less and those with a PI above the median (47.2%). Our results show that the proliferation index in gastric carcinomas has no prognostic relevance and therefore is of low clinical value.

Immature squamous metaplasia (focal atypical epithelial hyperplasia) of the pancreatic duct—immunohistochemical distinction from intraductal carcinoma

“…The MUC‐1 staining pattern in ICP was similar to that in normal pancreatic ductal epithelium, which may indicate that ICP maintains differentiation towards the latter . A high Ki67 labelling index in adenocarcinomas derived from various organs has been reported . The Ki67 labelling index was much higher in ICP samples (5–40%) than in ISMPD (0–3%), indicating increased proliferative activity of ICP.…”

Protein expression status in mucosal and submucosal portions of early gastric cancers and their predictive value for lymph node metastasis

“…Immunohistochemical markers including Ki‐67 labeling index have been suggested to have predictive value for LN metastasis in some studies , but it is controversial in other studies . The intratumoral heterogeneity of cell proliferation may be one contributable factor of the reasons for conflicting results.…”

“…For predicting LN metastasis in EGCs, it has been reported that gastric cancer patients with LN metastases had a significantly higher proliferation index using Ki‐67 immunostaining . However, the Ki‐67 labeling index in gastric cancer has been reported to have no predictable value for LN metastasis or prognostic relevance in other studies . One of contributable factors to this confusion may be heterogeneity of proliferative capacity in tumor area.…”

Diagnosis and Monitoring of Colorectal Cancer by L6 Blood Serum Polymerase Chain Reaction Is Superior to Carcinoembryonic Antigen-Enzyme-Linked Immunosorbent Assay

“…In a previous publication, the need for a panel of control measurements was emphasized. 4 There are indications in the literature that RT-PCR diagnosis of tumor-associated or tumor-specific antigens in blood or bone marrow can be influenced considerably by certain cytokeratins. Jung and coworkers 28 could detect neither CEA nor cytokeratin 19 (CK19) RT-PCR products either in bone marrow samples from healthy volunteers or in patients with hematologic malignancies, but such products were detected in 60 percent of patients with inflammatory diseases.…”

“…Results in the literature and from our own clinic show that the prognosis of patients with colorectal cancer is influenced by the occurrence of circulating tumor cells. [1][2][3][4] Prognosis based on ELISA measurements of CEA is highly controversial and may only be feasible by use of serial measurements. One important reason why CEA is established as a tumor marker 5 is that it is an inexpensive and standardized procedure that can be performed automatically.…”