Evaluation of Ki-67 marker in differentiating cervical intraepithelial neoplasia and benign lesions: A study of 50 cases

Abstract

Introduction: Cervical cancer is the worldwide third most common cancer and fourth most common cause of cancer related deaths in female population, accounting to approximately 453,300 cases per year and 275, 100 deaths in the year 2008.According to the latest WHO global cancer statistics, the cumulative risk (%) (Age 0-74) of cervical carcinoma is 0.9 with age adjusted ratio of 9.0 (Jemal et al., 2011). Supplementary methods using objective biomarkers are needed to achieve more accurate diagnosis.Ki-67 is a well known proliferative marker, useful for confirmation of the diagnosis in ambiguous cases and CIN grading. Aims: The aim of this study is to evaluate Ki-67 marker by immunohistochemical methods in differentiating CIN from benign cervical lesions. Materials and Methods: The study was done at Department of Pathology, MGMCH, Jaipur it was a Hospital-based observational study consisting of 50 cases. Statistical methods: sensitivity, positive predictive value, negative predictive value, and specificity was calculated. Results: Proliferative index was 50%in neoplastic cases. Accordingly scoring for Ki-67 stained nuclei was done with score 0 means no staining, 1 means weak positive (50%). In our study Statistical analysis of Ki-67 marker shows that sensitivity of this marker is 94.7%, specificity is 96.7%, positive predictive value 94.7%, negative predictive value 96.7% and accuracy is 96%.P value is Conclusion: In summary many studies have shown that there is statistically significant relation between proliferative activity, distribution of Ki-67 positive cells and CINgrade. Ki-67 antigen could be a tool to identify women who are at higher risk for progression and/or recurrence of cervical squamous precancerous lesion and in differenciating between benign and malignant cervical lesions. Keywords: Cervix, Ki-67, Benign, Malignant, Cervical intraepithelial neoplasia