Expression of Ki-67 can assist in predicting recurrences of low-grade analintraepithelial neoplasia in AIDS

PURPOSE: The incidence of anogenital squamous-cell carcinoma was observed t o have increased since the beginning of the human immunodeficiency virus in fection epidemic among male homosexuals, both with acquired immunodeficienc y syndrome and without acquired immunodeficiency syndrome. It seems that im munosuppression is the most important risk factor for the progression of an ogenital lesions, recurrences of anal condyloma, and development of anal ca rcinoma, in particular in acquired immunodeficiency syndrome. High-grade an al intraepithelial neoplasia was predominantly observed in the human immuno deficiency virus-positive men. We have also observed a high rate of recurre nces of anal lesions in cases of high-grade anal intraepithelial neoplasia. However, there are many cases of recurrences of low-grade anal intraepithe lial neoplasia that cannot be predicted by routine histologic studies. By u sing immunohistochemical methods, we studied the expression of Ki-67 in epi thelial cells of low-grade anal intraepithelial neoplasia of patients with acquired immunodeficiency syndrome to try to predict recurrence of these le sions. METHODS: Anal biopsies of 38 patients were studied retrospectively. Of these patients, 14 had no recurrences (Group 1), and 24 patients had rec urrence of the anal lesions before one year of follow-up (Group 2). RESULTS : The median percentage of Ki-67-positive cells in Group 1 was 6.3 +/- 7.03 and in Group 2 was 24.1 +/- 16,72. The difference between Groups 1 and 2 w as statistically significant (P < 0.001). CONCLUSIONS: Our results showed a high correlation between the percentage of Ki-67-positive cells and recurr ences. We concluded that Ki-67 counting in low-grade anal intraepithelial n eoplasia can aid in predicting recurrences and therefore aid in the follow- up of these patients.