C. Sittel et al., Ki-67 (MIB1), p53, and Lewis-X (LeuM1) as prognostic factors of recurrencein T1 and T2 laryngeal carcinoma, LARYNGOSCOP, 110(6), 2000, pp. 1012-1017
Objectives: Recently published data suggest a prognostic value of immunohis
tochemical proliferation markers for limited laryngeal carcinoma. Previous
studies have reported contrasting findings on this issue. In this context,
different treatment modalities may be responsible for contradictory finding
s. To study the relationship between proliferative activity-expressed by th
e immunohistochemical labeling index of proliferation-associated markers Ki
-67 (MIB1), Lewis-X (LeuM1), and proliferating cell nuclear antigen (PCNA)
and by p53 status-and treatment failure in a matched-pair study on recurren
t and nonrecurrent T1 and T2 glottic carcinoma having received primary tran
soral laser surgery. Methods: Twenty-one patients with tumor recurrence wer
e randomly selected and matched with 26 patients with nonrecurrent disease
regarding histopathological grading and age. MIB1 staining was used to dete
rmine the Ki-67 labeling index, and LeuM1 staining for detecting the Lewis-
X antigen; immunohistochemistry determined the p53 status and PCNA labeling
index. Results: The Ki-67 labeling index was significantly (P = .001) high
er in tumors from patients who had treatment failure (mean = 20.02%) than i
n patients who did not fail treatment (" honfailures") (mean = 9.95%). Carc
inoma with a Ki-67 (MIB1) labeling index above the median (15%) of the gene
ral study population showed a mean time to relapse of 23 months (n = 21), c
ompared with 50 months for cases (n = 26) below the median (P = .016). PCNA
labeling index correlated less impressively with tumor recurrence (mean =
28.59% for treatment failures, mean 21.75% for nonfailures, P = .022). Posi
tive detection of the Lewis-X antigen was significantly associated with rec
urrence (P = .015) and time to relapse (P = .006), Status of p53 was not a
significant prognostic factor. Conclusion: The Ki-67 (MIB1) labeling index
may be associated with early relapse of limited laryngeal carcinoma treated
with transoral laser surgery. Since the prognostic relevance of Ki-67 seem
s to be different for radiological and surgical concepts of treatment, Ki-6
7 might become useful as criterion of therapy selection. The Lewis-X antige
n, for the first time used on laryngeal carcinoma, seems to be a strong pro
gnostic marker deserving further investigations.