Immunohistochemical Study of Ki-67 Labelling Index in Neoplasms of Central Nervous System

Anuradha G. Patil, N. Bhargava, Megha M Wadone, A. Anita
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Abstract

Introduction: The central nervous system tumours show a varied histopathological spectrum. The cell proliferation index may provide an objective method for assessing tumour biology. The Ki-67 is considered to be the most reliable proliferative marker predicting the tumour behaviour of various systemic and intracranial neoplasms. As it reflects tumour proliferating potential, it helps in determining the grade and hence the likelihood of recurrence. This study was carried out considering that very few studies of Ki-67 Labelling Index (LI) is seen in Central Nervous System (CNS) neoplasms collectively. Aim: To study the Ki-67 LI in CNS neoplasms and the association of Ki-67 LI with different parameters like age, sex, World Health Organisation (WHO) grading and histological types. Materials and Methods: The present descriptive analytical study was conducted at Department of Pathology, Mahadevappa Rampure Medical College, Karnataka, India, attached to a tertiary care hospital, Kalaburagi, for a period of five years between 1st Aug 2013 to 31st July 2018 after approval from the Institutional Ethics Committee. The formalin-fixed and paraffin-embedded tissue sections were stained with haematoxylin and eosin. Immunohistochemistry (IHC) was carried out with Ki-67 antibody using standard protocol. The data was analysed using IBM SPSS software version 19.0. The descriptive statistics frequency and percentages were calculated. The morphological grading of CNS tumours was done and the distribution of Ki-67 LI values were analysed. Results: A total of 102 histopathologically diagnosed primary CNS tumours were included in the study. High incidence of CNS neoplasms was seen in 3rd to 4th decade with slight male preponderance. This study included 40 meningioma cases. Mean percentages of Ki-67 LI for grade I and grade II meningiomas were 3.3% and 4%, respectively. The Ki-67 mean value for Astrocytomas grade I was 5.6% and grade II was 8.7%. Grade IV Glioblastoma and Gliosarcoma showed mean value of 18% and 18.8%, respectively. It was observed that LI increased with increase in grade of the tumour. Schwannoma and Dysembryoplastic Neuroepethelial Tumour (DNET) showed Ki-67 LI of 2.9% and 2.6%, respectively. Mean value of Ki-67 LI of other primary CNS neoplasms were as follows: Medulloblastoma 53%, Atypical Teratoid/Rhabdoid Tumour (ATRT) 32%, Haemangiopericytoma 8%, Neurocytoma 4%, Malignant Peripheral Nerve Sheath Tumour (MPNST) 3%, Ganglioglioma 4% and Haemangioblastoma 4%. Conclusion: The Ki-67 LI is the simplest and the most reliable method for evaluating the cell proliferation. It has a great value in designating the exact grade of the tumour when used in combination with histopathological features. It can also be used for planning of adjuvant therapy in primary CNS neoplasms.
中枢神经系统肿瘤Ki-67标记指数的免疫组化研究
导言:中枢神经系统肿瘤表现出不同的组织病理谱。细胞增殖指数可为评价肿瘤生物学提供一种客观的方法。Ki-67被认为是预测各种全身和颅内肿瘤行为的最可靠的增殖标志物。由于它反映了肿瘤的增殖潜力,因此有助于确定肿瘤的级别和复发的可能性。本研究是考虑到Ki-67标记指数(LI)在中枢神经系统(CNS)肿瘤中的研究很少。目的:探讨中枢神经系统肿瘤的Ki-67 LI水平,以及Ki-67 LI与年龄、性别、世界卫生组织(WHO)分级及组织学类型的关系。材料和方法:经机构伦理委员会批准,本描述性分析研究于2013年8月1日至2018年7月31日在印度卡纳塔克邦Mahadevappa Rampure医学院病理学系进行,该医学院隶属于Kalaburagi三级保健医院,为期五年。福尔马林固定切片和石蜡包埋切片分别用苏木精和伊红染色。用Ki-67抗体按标准方案进行免疫组化(IHC)。采用IBM SPSS 19.0软件对数据进行分析。计算描述性统计频率和百分比。对中枢神经系统肿瘤进行形态学分级,分析Ki-67 LI值的分布。结果:本研究共纳入102例经组织病理学诊断的原发性中枢神经系统肿瘤。中枢神经系统肿瘤的高发见于第3至第4年,男性略占优势。本研究包括40例脑膜瘤病例。I级和II级脑膜瘤Ki-67 LI的平均百分比分别为3.3%和4%。星形细胞瘤I级Ki-67平均值为5.6%,II级为8.7%。IV级胶质母细胞瘤和胶质肉瘤的平均值分别为18%和18.8%。我们观察到LI随肿瘤分级的增加而增加。神经鞘瘤和胚胎发育异常神经上皮瘤Ki-67 LI分别为2.9%和2.6%。其他原发性中枢神经系统肿瘤Ki-67 LI平均值为:髓母细胞瘤53%,非典型畸胎瘤/横纹肌样瘤(ATRT) 32%,血管外皮细胞瘤8%,神经细胞瘤4%,恶性周围神经鞘瘤(MPNST) 3%,神经节胶质瘤4%,血管母细胞瘤4%。结论:Ki-67 LI是评价细胞增殖最简单、最可靠的方法。当与组织病理学特征结合使用时,它在指定肿瘤的确切分级方面具有很大的价值。它也可用于原发性中枢神经系统肿瘤的辅助治疗计划。
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