BORDERLİNE MÜSİNÖZ OVER TÜMÖRLERİNDE Kİ67'NİN PROGNOSTİK DEĞERİ

Abstract

Objective
 Ovarian borderline tumors (OBTs) are an intermediate
 type of ovarian neoplasm. Ovarian mucinous borderline
 tumors (MBT) are the second most common subtype
 of OBT. Because of their uncertain pathogenesis
 and biological behaviour they cannot be classified
 clearly into benign and malign categories. There is a
 need to identify a parameter that provides more prog-
 nostic information about the clinical course and can be
 evaluated easily in routine practice. Ki67 is a routinely
 used immunohistochemical marker that is strongly associated
 with cellular proliferation, including tumor cells.
 We aimed in this study to evaluate the prognostic
 significance and to determine prognostic cut-off value
 of Ki67 counting in the MBTs and to investigate its relationship
 with clinicopathologic features, recurrence,
 and long term survival status and also to provide more
 information to the literature.
 Material and Method
 A total of 20 cases diagnosed with ovarian mucinous
 borderline tumors were identified. Immunohistochemical
 studies were performed on the most representative
 sample of the tumor. Positive signal was nuclear and it
 was evaluated by two pathologists.
 Results
 Ki67 proliferating index (P.I) value with a median of
 15%(1-47%) and a mean of 16% Ki67 P.I. reached
 statistically significance at 20% cut-off value with
 progression and at 30% cut-off value with 5-year OS.
 (p=0.021 and p=0.032, respectively). Although the
 Ki67 P.I. tended to increase with age, there was no
 statistical association between Kİ67 P.I. and other clinicopathological
 parameters including tumor size, laterality,
 capsule integrity, intraepithelial carcinoma and
 focal atypia.
 Conclusion
 In our study, recurrence was more frequent when Ki67
 was greater than 20%, and 5-year survival was lower
 when Ki67 was greater than 30%, suggesting that
 the Ki67 index was associated with a more aggressive
 course and death. Therefore, we predicted that
 Ki 67 would be useful in determining the frequency of
 follow-up of patients and predicting their prognosis.
 However, we think that this result should be supported
 by larger series.