Ann Surg Treat Res.  2015 Apr;88(4):200-207. 10.4174/astr.2015.88.4.200.

Ki-67 and p53 expression as a predictive marker for early postoperative recurrence in pancreatic head cancer

• Kim H
• Park CY
• Lee JH
• Kim JC
• Cho CK
• Kim HJ

• KMID: 2167016
• DOI: http://doi.org/10.4174/astr.2015.88.4.200

Abstract

PURPOSE
This study aimed to evaluate the clinical significance of Ki-67 and p53 expressions in patients with pancreatic head cancer.
METHODS
Between May 2008 and April 2013, immunohistochemical staining for Ki-67 and p53 was performed in 34 patients with pancreatic head cancer (ductal adenocarcinoma). All 34 patients underwent pancreaticoduodenectomy at Chonnam National University Hwasun Hospital, Hwasun, Korea. Clinical and histopathological characteristics were analyzed, relative to p53 expression.
RESULTS
Thirty (88.2%) and twenty-one (61.7%) of the 34 pancreatic head cancers exhibited positive expression of Ki-67 and p53, respectively. Patients expressing Ki-67 and p53 experienced more frequent tumor recurrences within 1 year after surgical resection (P = 0.003 and P = 0.030, respectively). However, no correlation was detected between Ki-67 and p53 expression. Ki-67 expression was correlated with pathological grade, lymph node metasatsis, and clinical stage (P < 0.05). Importantly, Ki-67 was the independent predictive factor for postoperative recurrence within 1 year in both univariable and multivariable analyses (odds ratio, 27.219; 95% confidence interval, 1.403-528.135; P = 0.029).
CONCLUSION
The expression of Ki-67 and p53 are significantly related to early postoperative recurrence within 1 year after surgical resection in pancreatic head cancer. Especially, Ki-67 was the independent predictive factor for postoperative recurrence within 1 year. Therefore, immunohistochemical staining for Ki-67 and p53 may be applied as a predictive marker for early postoperative recurrence in pancreatic head cancer.

Keyword

Ki-67 antigen; Tumor suppressor protein p53; Pancreatic ductal carcinoma; Immunohistochemistry; Risk factors

MeSH Terms

Carcinoma, Pancreatic Ductal
Head
Head and Neck Neoplasms*
Humans
Immunohistochemistry
Jeollanam-do
Ki-67 Antigen
Korea
Lymph Nodes
Pancreaticoduodenectomy
Recurrence*
Risk Factors
Tumor Suppressor Protein p53
Ki-67 Antigen
Tumor Suppressor Protein p53

Figure

• 

  Fig. 1 Representative immunohistochemical staining of p53 and Ki-67 in pancreatic head cancer. Negative expression for p53 (A, ×200) and positive expression for p53 (B, ×200). Positive staining suggests a mutant p53 gene with accumulation of mutant p53 proteins. Weak expression (C, ×100), moderate expression (D, ×100), and strong expression for Ki-67 (E, ×100).

• 

  Fig. 2 Cumulative recurrence rates after surgical resection according to the degree of Ki-67 (A) and p53 expression (B) in pancreatic head cancer tissue. Overall recurrence-free survival rates were not different between patients with Ki-67 and p53 expression (P = 0.055 and P = 0.053, respectively). However, the recurrence-rate within 1 year after surgical resection was significantly lower in pancreatic head cancer patients expressing Ki-67 (P = 0.003) and p53 (42.8% vs. 84.6%, P = 0.030).

• 

  Fig. 3 Cumulative survival rates after surgical resection according to the degree of Ki-67 (A) and p53 expression (B). Cumulative overall survival rates were not different between patients with Ki-67 and p53 expression (P = 0.210 and P = 0.573, respectively).

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