KI-67 EXPRESSION AS A PROGNOSTIC MARKER IN PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Ki-67 expression in rumours has been shown to be associated with progn osis in patients with hepatocellular carcinoma (HCC). In this study, p rimary HCC samples were obtained from 67 patients undergoing surgical resection. None of these patients had been subjected previously to any other form of therapy, such as arterial embolization or chemotherapy. Histologically normal liver tissues from liver resection for metastat ic colon cancer were taken as controls (n = 8). Monoclonal antibody ag ainst Ki-67 was used for immunostaining and flow cytometry was used to measure tumour DNA ploidy. The mean Ki-67 labelling index (percentage of Ki-67-positive cells) of the HCC (26 +/- 22%; range 0.1-89%) was s ignificantly higher than that of the normal controls (39 +/- 0.8%, P < 0.05). The mean Ki-67 labelling index (19 +/- 15%; n = 28) of the tum ours with diploid DNA pattern was significantly lower than those with aneuploid DNA pattern (32 +/- 25%, n = 39; P = 0.01). Hepatocellular c arcinoma patients (n = 47) with Ki-67 index >10% had a significantly l ower disease-free and overall survival than those (n = 20) with Ki-67 index less than or equal to 10% (P = 0.0009 and P = 0.02, respectively ). Multivariate analysis showed that Ki-67 expression and tumour node metastasis stage were two independent prognostic factors for disease-f ree and overall survival rates. Our results suggest that the expressio n of Ki-67 is an independent prognostic indicator for patients with HC C after resection and could be of assistance in the decision-making of adjuvant therapy.