Ki‐67 immunostaining and other prognostic factors including tobacco smoking in patients with resected nonsmall cell lung carcinoma

• Published in: Cancer Vol. 89; no. 7; pp. 1457 - 1465
• Main Authors: Shiba, Mitsutoshi, Kohno, Hiromasa, Kakizawa, Kimitaka, Iizasa, Toshihiko, Otsuji, Mizuto, Saitoh, Yukio, Hiroshima, Kenzo, Ohwada, Hidemi, Fujisawa, Takehiko
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.10.2000; Wiley-Liss
• Subjects: Aged; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - immunology; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; Cell Transformation, Neoplastic; Female; Humans; Ki-67 Antigen - analysis; Ki‐67 antigen; Lung; Lung Neoplasms - immunology; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Multivariate Analysis; nonsmall cell lung carcinoma (NSCLC); Prognosis; Retrospective Studies; Risk Factors; Sensitivity and Specificity; Smoking - adverse effects; surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Survival Analysis; tobacco smoking; Human; Immunohistochemistry; Cell proliferation; Lung disease; Prognosis; Respiratory disease; Tobacco smoking; Biological marker; Surgical resection; Malignant tumor; Bronchopulmonary; Pathology; Treatment; Surgery; Ki67 antigen; Bronchus disease; Non small cell carcinoma
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20001001)89:7<1457::AID-CNCR7>3.0.CO;2-L

BACKGROUND To estimate the effectiveness of expression of the tumor proliferative marker Ki‐67 antigen (Ki‐67) as a postoperative prognostic marker, the authors analyzed Ki‐67 expression and its correlation with postoperative survival and other clinicopathologic factors, including preoperative smoking habits, in patients with resected nonsmall cell lung carcinoma (NSCLC). METHODS A total of 156 patients with resected NSCLC at the study institution were investigated. Postoperative survival rates were estimated based on demographic and clinicopathologic factors, including Ki‐67 expression and preoperative tobacco smoking habits. RESULTS The overall postoperative 5‐year survival rate in patients with high Ki‐67 labeling indices (≥ 20%) was 39.6% compared with 67.7% in patients with low Ki‐67 labeling indices. This finding was significant for all resected cases and for each pathologic disease stage (P < 0.05). The postoperative 5‐year survival rate in patients with a history of heavy smoking (≥ 30 pack‐years) was 47.6% compared with 62.5% for other patients (P = 0.027). This result was especially significant in patients with International Union Against Cancer Stage I disease and in patients with nonsquamous cell carcinoma (P < 0.03). The authors also observed a positive correlation between the Ki‐67 labeling index and preoperative smoking habits (P = 0.0002). Multivariate analysis demonstrated that lymph node involvement, tumor differentiation, and Ki‐67 labeling index were significant prognostic factors in NSCLC (P < 0.01). CONCLUSIONS Tumor Ki‐67 expression is a strong prognostic factor in NSCLC, especially adenocarcinoma. It may be hypothesized that tobacco mutagenicity may play a role in the growth and extension of NSCLC, which is one of the major impediments to postoperative survival in patients with a history of heavy smoking. Cancer 2000;89:1457–65. © 2000 American Cancer Society. Expression of the tumor proliferative marker Ki‐67 and preoperative smoking habits, as well as lymph node involvement and T classification, were found to be significant prognostic markers in patients with resected nonsmall cell lung carcinoma. A positive correlation between Ki‐67 expression and preoperative smoking habits was observed.