پلي كولونال در كارسينوم ترانزيشنال مثانه KI-76 تظاهر

Polyclonal Ki-67 expression in transitional cell carcinoma of the bladder

Current methods of predicting prognosis in transitional cell carcinoma (TCC) of the bladder fail to provide consistently reliable information about future tumor behavior. The polyclonal antibody Ki-67 recognizes a nuclear antigen exclusively present in cells in the cell cycle. The Ki-67 reactivity has been shown to correlate with conventional prognostic indicators in several tumors. We studied the proliferative activity of 40 cases of transitional cell carcinomas of the bladder using polyclonal Ki-67 and determined the proportion of cells undergoing active division. A significant correlation was observed between cells with activated DNA (Ki-67), histological grading and staging (P< 0.0001). The differences of mean Ki-67 index in the grade IIa versus IIb (using Pauwell classification) was also significant (P<0.044). Those cases which were limited to epithelial layer (stage Ta) show lower Ki-67 positivity than those infiltrating the lamina properia or deeper layers (stage T1, T2, T3&T4) (P< 0.05). The differences between stage T1 versus T2 and T3 versus T4 were not statistically significant (P>0.05). The tumors with lymphatic and vascular invasion showed greater Ki-67 positivity than non-invasive tumors (P<0.01) These results suggest that the immunohistochemical assessment of the proliferative activity of transitional tumors of the bladder, using polyclonal antibody Ki-67 correlates with higher tumor stage and grade. Ki-67 staining provides an easy method of determining tumor cell turnover that might provides additional prognostic information. The results also indicate that the number of Ki-67 positive cells in grade II tumors may be useful aid in separating grade II TCC with favorable prognosis (IIa) from those with a poor clinical outcome (IIb).