Prognostic and Predictive Impact of Ki-67 in Premalignant and Malignant Squamous Cell Lesions of Oral Cavity

Abstract

Introduction Oral squamous cell carcinoma, the fifth most common cancer worldwide, is a major cause of morbidity and mortality in India. It most commonly occurs in middle-aged and older individuals. Typically, they tend to be preceded by a premalignant state for a long time. The present study evaluates the clinicopathological profile of patients with oral lesions and the role of malpractices that promote carcinogenesis in the oral mucosa and the use of Ki-67 as an important predictor of the same. Materials and methods The expression of Ki-67 was studied in paraffin-embedded tissue sections of oral lesions of all the cases after taking a detailed history and examination. Results The study was conducted on 65 patients with 25 dysplastic and 40 malignant lesions. Males were affected more frequently than females. The most common age group affected was 31 to 60 years with mean age of 45.4 years. Anterior twothird of tongue (41%) was the most commonly affected site. 95% of the patients had a history of addiction in form of smoking, tobacco chewing and betel nut. Out of 25 cases of dysplasia, 11 showed low expression while out of 40 cases of squamous cell carcinoma only three showed low and 29 showed high expression of Ki-67. Conclusion The expression of Ki-67 correlates well with the disease progression from dysplasia to carcinoma of the oral cavity. It is therefore a marker of malignant transformation and carcinogenesis in oral premalignant lesions and in future it may serve as a prognostic tool in the early detection of malignancy. How to cite this article Maheshwari V, Sharma SC, Narula V, Verma S, Jain A, Alam K. Prognostic and Predictive Impact of Ki-67 in Premalignant and Malignant Squamous Cell Lesions of Oral Cavity. Int J Head Neck Surg 2013;4(2):61-65.

Nuclear Epidermal Growth Factor Receptor Overexpression as a Survival Predictor in Oral Squamous Cell Carcinoma

“…In the subjects with premalignant changes, the expression of Ki-67 increased statistically significantly with the progression of dysplasia ( p = 0.005), which is consistent with data from the literature. Sharma, like us, demonstrated a positive correlation between Ki-67 expression and disease progression from low-grade dysplasia to high-grade dysplasia to OSCC in 65 subjects, 40 of whom had OSCC and 25 of whom had premalignant changes [ 32 ]. The increase in Ki-67 expression with progression of dysplasia in leukoplakias is the result of an observational study conducted by researchers from India in 2020 on 786 subjects with leukoplakia, of whom 126 had epithelial dysplasia, and 14 patients developed OSCC [ 33 ].…”

Histopathological Grading of Oral Squamous Cell Carcinoma and Its Correlation With Ki-67 - A Proliferative Marker

“…In the study carried out by Maheshwari et al 16 (2013) maximum cases were of squamous cell carcinoma of tongue which comprise 41.54%, of total cases of oral squamous cell carcinoma which were followed by floor of mouth and other parts of oral cavity. Eman et al (2014) in their study have found most common site of oral squamous cell carcinoma was tongue that is 40% of the cases followed by floor of mouth (17.1%), lip (14.3%) and hard palate (8.6%).…”

“…15 Based on the labeling index, the sections were scored from 1 to 3 for ki-67 expression as follows 16 Given section stain with a) h & e stain shows sheets of malignant squamous cells along with keratin pearls b) low proliferation (<30%) of ki-67 (brownish nuclear discoloration) in well differentiated squamous cell carcinoma (40x view).…”