KI-67 LABELLING INDEX IN UROTHELIAL NEOPLASM

Abstract

Urothelial neoplasms can be classified as non-invasive & invasive lesions. The major prognostic factors are degree of differentiation and depth of invasion in urothelial tumors. Ki-67 is a non- histone nuclear protein marker of cell proliferation which is encoded by MKi-67 gene in humans. This study evaluates and correlate immunohistochemical Ki-67 expression in Non-invasive & Invasive urothelial neoplasm. This retrospective study is done in the Department of Pathology of L.N. Medical College and J.K. Hospital, Bhopal. Urothelial Neoplasm cases diagnosed from January 2019 to January 2022 were included, & relevant clinico-pathological data and their Ki-67 Labelling Index was evaluated & correlated. Total 60 cases were studied, 30 had invasive carcinoma whereas, 30 had non-invasive neoplasm. Ki-67 expression (>13%) was seen maximum in invasive cancers i.e 40% cases, whereas (<13%) was seen maximum in non-invasive neoplasms i.e 38.3%. A statistically significant expression of Mean Ki-67 Labelling Index was observed that increased from papilloma to PUNLMP, Non- Invasive urothelial neoplasm Low grade & High grade in non-invasive urothelial neoplasm (p<0.001), and from lamina propria invasive to muscle invasive urothelial cancers (p=0.013). A Higher tumor proliferation of greater than 13% was significantly related to greater tumor size (p=0.04). Ki-67 labelling index being a measure of tumor proliferation is related to tumor histological grade. Large urothelial tumor size was associated to high Ki-67 LI and was not strongly associated with age and gender. Therefore Ki-67 expression can be used as Diagnostic & Prognostic marker in urothelial tumors.