Mitotic Index Is the Best Predictive Factor for Survival of Patients with Resected Hepatocellular Carcinoma

Abstract

Background: In patients with hepatocellular carcinoma (HCC), tumor recurrence is not infrequent after resection. It is presumed that characteristics of the tumor such as cellular malignancy might influence the prognosis of the patients in association with tumor stage and radicality of the procedure. Methods: Univariate and multivariate analyses were used to retrospectively determine the clinicopathologic factors potentially related to survival in 40 patients who underwent hepatectomy for HCC. Results: In univariate analysis, tumor stage I or II, mitotic index of 4 or less/10 random high-power fields, solitary tumor, and curative resection were significantly correlated with better survival. In multivariate analysis, the mitotic index and surgical curability were independently significant variables influencing survival of patients, and the mitotic index was the best predictive factor. A highly significant correlation was found between the mitotic index and Ki-67 labeling index. Compared to tumors with a mitotic index of 4 or less, those with a mitotic index of 5 or more had a higher association with multiple tumors and advanced tumor stage, which preclude curative resection. Conclusion: Analysis of the mitotic index is quite simple, and the mitotic index could be a useful factor for predicting the long-term survival of patients with HCC following hepatic resection.

The Effect of Amrinone on Liver Regeneration in Experimental Hepatic Resection Model1

“…When these findings are compared, MI was higher at 24 (2.6%) and 48 h (6.4%) in our study [21]. It is reported that MI is an important parameter providing information about survival [28]. Several authors have shown that this proliferation-associated antigen is expressed during all active parts of the cell division cycle (G1, S, G2, and M) but is absent in resting cells (G0) [29,30].…”

Antioxidative, antiapoptotic, and proliferative effect of curcumin on liver regeneration after partial hepatectomy in rats

“…Selzner and Clavien (2000) found the MIs at the 24 and 48 h, 2% and 3%, respectively. It is reported that MI is an important parameter providing information about survival (Ouchi et al, 2000). Several authors have shown that this proliferation-associated antigen is expressed during all active parts of the cell division cycle (G1, S, G2, and M) but is absent in resting cells (G0) (Assy and Minuk, 1997;Assy et al, 1998).…”

Single Dose of Anti-Transforming Growth Factor-β1 Monoclonal Antibody Enhances Liver Regeneration After Partial Hepatectomy in Biliary-Obstructed Rats

“…Under normal conditions mitotic activity does not occur in undamaged liver, whereas mitotic activity increases in liver with tissue damage caused by toxins or volume loss [15,33]. The MI represents the relative number of cells undergoing mitosis, and it is an important parameter providing information about the likelihood of survival [34]. In another study, mitotic cell counts in rats that underwent 70% PHx were higher at 24 and 48 h after PHx than at 72 h and later [35].…”