Over-expression of Ki-67 as a predictor of lymph node metastasis in penile cancer patients

Abstract

Introduction: Penile cancer is a moderately common malignancy in developing countries. Metastasis to regional lymph nodes is an essential factor in a patient’s prognosis, as its occurrence predicts poor patient prognosis. As micro-metastasis occurs in more than 25% of cases, the need for more accessible diagnostic tools is necessary. Ki-67 is commonly used as a marker of proliferation associated with tumor grade and lymph node metastasis. Methods: Samples were taken from penile cancer patients between 2013 to 2018, in the form of formalin-fixed paraffin-embedded (FFPE) blocks were analyzed. Patient demographic data, current and pre-cancer condition, cancer staging, outcomes, and other results of adjuncts and treatment modalities were obtained from medical records. Immunohistochemistry analysis was carried out on FFPE preparations. Under 20% of nuclei stained was considered as low-expression and more than 20% of nuclei stained was considered as Ki-67 over-expression. Data processing and analysis were carried out using SPSS software. Results: In total, 48 FFPE samples were analyzed, with a mean patient age of 50.79 (±9.51 SD). For all patients, the type of pathology was squamous cell carcinoma. Node metastasis was positive in 34 patients (70.8%) and negative in 14 patients (29.2%). Statistical analysis was carried out using the Chi-Square test, resulting in a significant correlation between the expression of Ki-67 and lymph node metastasis in penile squamous cell carcinoma (p=0.045). Conclusion: Over-expression of Ki-67 were found in penile cancer patients with lymph node metastasis. Therefore, Ki-67 might be useful in predicting lymph node metastasis in penile cancer patients.

Prognostic predictors of lymph node metastasis in penile cancer: a systematic review

“…The antioxidant and tumor sup-pressor superoxide dismutase (SOD2) overexpression (overexpression=present in >50% of cells; seen in 44.8% of penile SCCs) was also predictive of lymph node involvement: 52.8% of patient with nodal involvement had the above criteria for overexpression compared to 24.6% with <50% of cells overexpressing (10). Warli et al recently reported that overexpression (>20% of nuclei) of the nuclear proliferative protein Ki-67 is associated with increased movement of SCC of the penis to inguinal lymph nodes independent of tumor stage and grade (21). Diffuse PD-L1 expression is significantly predictive, which serves as a clinically relevant marker because of recent advancements targeting PD-L1 with immunotherapeutic agents (17).…”

Spontaneous expression of the gene of KI67 and P53 in cynomolgus monkeys infected with papillomavirus

“…Protein Ki-67 is considered a good indicator of cell proliferation and correlates with tumor growth [ 13 , 14 ]. Cell proliferation is one of the main factors in the biological mechanisms of oncogenesis; therefore, several studies have shown that the activity of cell proliferation is linked with the prognosis of certain cancers such as cervical cancer, breast cancer, carcinoma of the penis, and larynx [ 15 - 18 ]. Ki-67 protein has also been reported to correlate with tumor aggressiveness and has prognostic and predictive value in breast and colon cancer, melanoma, and lymphoma patients [ 19 , 20 ].…”