PROGNOSTIC-SIGNIFICANCE OF THE MIB-1 PROLIFERATION INDEX FOR PATIENTSWITH SQUAMOUS-CELL CARCINOMA OF THE ESOPHAGUS

Background. A number of studies have indicated that the ki-67 prolifer ation index is of important prognostic significance for a variety of n eoplasias. It was the aim of this study to investigate whether any cor relation exits between the MIB-1 proliferation index and various clini copathologic parameters in squamous cell carcinomas of the esophagus f rom 72 patients (20 women: median age, 64 years; range, 45-79 years; a nd 52 men: median age, 61 years; range, 43-77 years). Methods. Prolife rative activity was determined using an immunohistochemical method wit h monoclonal antibody MIB-1 (ABC method), for tumor samples obtained f rom individuals who underwent esophagectomy in the period from 1983 to 1991. The percentage proliferation index (PI) was calculated as the n umber of positive cells divided by the total number of cells examined. Thirty-nine patients (54%) died of recurrence of esophageal cancer, w ith a median survival span of 15 months (range, 1-58 months). Thirty-t hree patients (46%) were still alive at the time of this study; their median follow up was 57 months (range, 40-98 months). Results. Signifi cant differences between proliferative index values were recorded for the following parameters: survival rate, P < 0.0001; presence of lymph node metastasis, P < 0.05; size of the primary esophageal lesion, P < 0.01; proliferation pattern of the tumor, P < 0.01; and age of the pa tients, P < 0.05. No correlation was found regarding histologic differ entiation, clinical stage, location of the lesion, intraepithelial can cerous spread, lymphatic and blood vessel invasion, and sex of the pat ients. Conclusion. The MIB-1 proliferation index may be a powerful pro gnostic marker for patients with squamous cell carcinomas of the esoph agus.