Abstract
Introduction: Penile cancer is a moderately common malignancy in developing countries. Metastasis to regional lymph nodes is an essential factor in a patient’s prognosis, as its occurrence predicts poor patient prognosis. As micro-metastasis occurs in more than 25% of cases, the need for more accessible diagnostic tools is necessary. Ki-67 is commonly used as a marker of proliferation associated with tumor grade and lymph node metastasis. Methods: Samples were taken from penile cancer patients between 2013 to 2018, in the form of formalin-fixed paraffin-embedded (FFPE) blocks were analyzed. Patient demographic data, current and pre-cancer condition, cancer staging, outcomes, and other results of adjuncts and treatment modalities were obtained from medical records. Immunohistochemistry analysis was carried out on FFPE preparations. Under 20% of nuclei stained was considered as low-expression and more than 20% of nuclei stained was considered as Ki-67 over-expression. Data processing and analysis were carried out using SPSS software. Results: In total, 48 FFPE samples were analyzed, with a mean patient age of 50.79 (±9.51 SD). For all patients, the type of pathology was squamous cell carcinoma. Node metastasis was positive in 34 patients (70.8%) and negative in 14 patients (29.2%). Statistical analysis was carried out using the Chi-Square test, resulting in a significant correlation between the expression of Ki-67 and lymph node metastasis in penile squamous cell carcinoma (p=0.045). Conclusion: Over-expression of Ki-67 were found in penile cancer patients with lymph node metastasis. Therefore, Ki-67 might be useful in predicting lymph node metastasis in penile cancer patients.
Highlights
Penile cancer is a moderately common malignancy in developing countries
Regional lymph node involvement can be an essential factor in patient prognosis, as its occurrence is a predictor of poor prognosis
Ki-67 expression level was divided into two groups; more or less than 20%
Summary
Penile cancer is one of the rare malignancies in men in developed countries. Examination of primary lesions, regional lymph nodes, and distant metastasis is beneficial in determining the management of penile cancer. Lymphatic metastasis in penile cancer follows the anatomical drainage route, which originates from the inguinal lymphatic nodes, drains to both superficial and deep and pelvic lymphatic nodes. As it holds an important role in predicting patient’s prognosis and survival, diagnosis and treatment of lymph node metastasis is essential. Ki-67 is widely used as a proliferation marker related to tumor grade and lymph node metastasis in penile cancer[7,8]. We will look at the association of Ki-67 with lymph node metastasis in patients with penile cancer
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