Utility of Immunohistochemical Expression of Ki-67 in Liver Cirrhosis and Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma is a primary malignancy of the liver and occurs predominantly in patients with underlying chronic liver disease and cirrhosis. The incidence of hepatocellular carcinoma is highest in Asia and Africa, where there is higher predisposition to chronic liver disease and subsequent development of hepatocellular carcinoma. The most widely used proliferation-associated marker is Ki-67, which is a nuclear antigen present only in proliferating cells. To study the immunohistochemical expression of Ki-67 in liver cirrhosis and hepatocellular carcinoma and its association to the progression of cirrhosis to hepatocellular carcinoma. This is a retrospective study conducted on estimated sample size of 26 formalin fixed paraffin embedded tissue blocks of histopathology proven liver cirrhosis/ hepatocellular carcinoma specimens received in the Department of Pathology at a tertiary care center. The immunohistochemical markers are used to evaluate Ki-67 levels in these specimens. Ki-67 expression was positive in 20% of cirrhotic specimens and 66% of hepatocellular carcinoma patients. There may be a possible relationship between Ki-67 expression and changes of the liver from cirrhosis to hepatocellular carcinoma. The Ki-67 antigen expression was relatively low in cirrhosis and high in hepatocellular carcinoma, the increased expression indicating the neoplastic growth. Further studies are required for quantification of such association to be used for diagnostic and prognostic significance.