Expression of topoisomerase II and Ki-67 in cervical carcinoma - clinicopathological study using immunohistochemistry

Aim. To study the correlation. between the expression of topoisomerase II a nd Ki-67 antigen and disease outcome in cervical squamous cell carcinomas. Experimental design. Forty-nine cervical carcinomas, 10 cases of high-grade cervical intraepithelial neoplasia (CIN II-III) and 5 control cervices wer e stained by monoclonal antibodies for topoisomerase II and Ki-67 (MIB-1 cl one). Nuclear counts were correlated with patient age, tumor stage, histolo gical grade and survival. Results. Thirteen patients died of disease, 35 remained free of disease, an d one patient was lost to follow up. Ki-67 counts were higher in CIN lesion s, when compared to both invasive carcinomas and control cervices. Topoisom erase II counts were comparable for CIN and invasive tumors. No immunoreact ivity for topoisomerase was detected in control cases. Neither stage nor gr ade was associated with nuclear counts using either marker. In multivariate survival analysis, stage (p=0.001), grade (p=0.03) and older patient age ( p=0.02) predicted poor survival. Ki-67 counts predicted survival with borde rline significance (p=0.07), while topoisomerase II counts were not related to survival. Conclusion. Ki-67 and topoisomerase II counts do not appear to have a signi ficant role in the prediction of survival in cervical squamous cell carcino ma.