The role of MIB-1 index in the prognosis of resectable pancreatic head cancer

BACKGROUND/AIMS: Cell kinetics are important indicators of the biological b ehavior of various human tumors. In this study, we evaluated the prognostic values of the proliferative factors including MIB-1 index, DNA ploidy and S-phase fraction, and further determined the independent prognostic factors in pancreatic head cancer after pancreatoduodenectomy. METHODOLOGY: Patients with pancreatic head cancer undergoing pancreatoduode nectomy were included. Cell proliferative parameters including MIB-1 index, DNA ploidy and S-phase fraction measured by flow cytometry were evaluated and compared with the conventional clinicopathologic factors. RESULTS: There were 21 resectable pancreatic head cancers. By univariate an alysis MIB-1 index, cell differentiation and lymphovascular invasion were s ignificant prognostic factors. The 5-year survival rate was 22.2% for overa ll patients and 29.2% for patients with MIB-1 less than or equal to 11%, wh ile it was 0% for MIB-1 index >11%, p=0.011. Tumors without lymphovascular invasion had significantly better prognosis than those with lymphovascular invasion (median survival: 38 vs. 10 months, p=0.009). The median survival was significantly longer for well-differentiated cancers than for moderatel y and poorly differentiated cancers (44 vs. 11 and 9 months, p=0.038). Ther e was no correlation between the MIB-1 index and the other 2 conventional p rognostic factors. After multivariate analysis, only the MIB-1 index emerge d as the independent prognostic factor. CONCLUSIONS: MIB-1 index played a significant role in the prognosis of the resectable pancreatic head cancer and could potentially complement the conv entional factors in predicting the prognosis and determining the optimal tr eatment strategy. MIB-1 index was also an important independent prognostic factor.