Proliferation index and karyometric features of pancreatic intraductal proliferative lesions

The increasing frequency and poor prognosis in pancreatic cancer prompt us to search for morphological lesions being a substrate for its development. Studies of autopsy and surgically resected material as well as recent molec ular studies have proved that one of the possible pathways of pancreatic ne oplasia is the intraepithelial proliferation-dysplasia-cancer sequence. In the present paper we studied the proliferative activity (Ki-67 index) in pa ncreatic intraepithelial proliferative lesions and its correlation with geo metric features of cell nuclei as signs of increasing dysplasia. The studie s were carried out in a group of 35 patients operated on for pancreatic can cer, chronic pancreatitis and other conditions not associated with the panc reas. We used immunohistochemical methods and basic morphometric parameters . The results of our studies indicate that the cell proliferative activity depends both on the type of epithelial proliferation and underlying pancrea tic disease. The values of Ki-67 index are significantly different in low-g rade proliferation (flat and papillary hyperplasia) and high-grade prolifer ation (atypical papillary hyperplasia and carcinoma in situ). A set of kary ometric features correlates with Ki-67 index but there is no single feature which would have a diagnostic value.