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New Indian Journal of Surgery

Volume  9, Issue 5, Sep-Oct 2018, Pages 653-657
 

Original Article

Role of Ki-67 as a Prognostic Marker in Cancer Gall Bladder- a Study from an Endemic Region

Vaibhav Raj Gopal1, Surender Kumar2, Nuzhat Hussain3, H.S. Pahwa4, Abhinav Arun Sonkar5, Awanish Kumar6, Mithlesh Bhargav7

1Senior Resident 2Professor 4Professor 5Professor and Head 6Professor, Department of Surgery, King George’s Medical University, Lucknow, Uttar Pradesh 226003, India. 3Professor and Head, Department of Pathology, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh 226003, India. 7Senior Resident, Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226003, India.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9518.21

Abstract

Introduction: The etiopathogenesis of gallbladder cancer is a multistep process and hardly any of the existing biomarker(s) have a positive relation with the clinico-pathological parameters and outcome. Ki-67, a proliferative marker, is a fair prognostic indicator in cancers like the breast. The present study was conducted to assess its validity for the same and its influence on the treatment in gallbladder cancer. Methodology: Histopathological examination and immunohistochemistry for Ki-67 was performed on 41 patients of GBC and 31 cases of gallstone disease in the age of 40-70. Follow up was done at 3 months by history and physical examination. Student’s unpaired t-test, ANOVA test, Chi square test and Pearson correlation coefficient analysis were applied to assess the relation of mean Ki-67 value to the TNM status, pathological grade, clinicopathological variables, stage and postoperative outcome at 3 months. Results: Mean Ki- 67 levels were significantly raised in the malignant cases (40.00±17.42) as compared to benign (2.22±1.54, p=0.0001). Significantly higher Ki-67 levels were noted in gallbladder cancer patients with deranged liver function tests (p<0.05). Mortality within 3 months was associated with significantly higher Ki-67 (45.66±21.11, p=0.0001). Similarly, mean Ki-67 was significantly high
in patients with nodal metastasis (47.05±17.23, p=0.03). However, no significant difference was noted in relation to the tumour (T) (p>0.05) and distant metastatic (M) status (p=0.77) and the stage (p=0.21).
Conclusion  Higher Ki-67 index suggests an advanced disease in the form of nodal metastasis and jaundice. It has an independent and inverse impact on the prognosis. Due to its overexpression in gallbladder cancer, it can be exploited for targeted therapy. 

Keywords: GBC; Gall Bladder Cancer; Ki-67; IHC; Immunohistochemistry  


Corresponding Author : Surender Kumar, Professor, Department of Surgery, King George’s Medical University, Lucknow, Uttar Pradesh 226003, India