Low nuclear proliferative activity is associated with nonmetastatic islet cell tumors.

Abstract

CONTEXT:

Traditional morphologic features of tumor aggression are of limited value in predicting the malignant behavior of endocrine neoplasms. We explored the potential value of nuclear proliferative activity (using Ki-67 immunostaining with semiquantitative scoring) in predicting the clinical behavior of pancreatic islet cell tumors (ICTs), and we correlated this characteristic with hormone expression.

OBJECTIVE:

To evaluate whether Ki-67 immunostaining using a semiquantitative scoring system has value in predicting the clinical behavior of pancreatic ICTs.

DESIGN:

We studied 39 pancreatic ICTs from 39 patients. Twenty-two ICTs did not metastasize in a median follow-up period of 91 months. The remaining 17 neoplasms did produce metastases (8 in liver, 7 in regional lymph nodes, and 2 in peritoneum). Immunohistochemistry was performed using antibodies to Ki-67 and pancreatic hormones (insulin, glucagon, gastrin, somatostatin, pancreatic polypeptide, vasoactive intestinal polypeptide, and corticotropin). A semiquantitative Ki-67 grading system was followed. The nuclear proliferative activity, as determined by a positive reaction for Ki-67, was considered low (<5% of cells staining positively), intermediate (5%-25% of cells staining positively), or high (>25% of cells staining positively).

RESULTS:

The majority of the nonmetastatic ICTs (16 cases, 73%) demonstrated either negative or low staining for Ki-67 (P <.001). Conversely, all metastatic ICTs expressed at least an intermediate-grade reaction. High nuclear proliferative activity was only seen in metastatic neoplasms (3 cases, 17%). There was no relationship between immunoexpression of pancreatic hormones and nuclear proliferative activity by either group of tumors.

CONCLUSION:

An ICT with low nuclear proliferative activity is unlikely to metastasize, whereas high proliferative activity is associated with a metastatic phenotype. Immunohistochemical assessment of Ki-67 using a semiquantitative scoring system is a simple and reliable detection method of cellular proliferative activity in ICTs of the pancreas.

• Authors: Merce Jorda, Zeina Ghorab, Gustavo Fernandez, Mehdi Nassiri, Andrew Hanly, Mehrdad Nadji
• Journal: Archives of pathology & laboratory medicine (Arch Pathol Lab Med) Vol. 127 Issue 2 Pg. 196-9 (Feb 2003) ISSN: 1543-2165 [Electronic] United States
• PMID: 12562234 (Publication Type: Journal Article)

Chemical References

• Ki-67 Antigen
• Pancreatic Hormones

Topics

• Adult
• Aged
• Carcinoma, Islet Cell (chemistry, pathology, secondary)
• Cell Division
• Cell Nucleus (pathology)
• Female
• Follow-Up Studies
• Humans
• Ki-67 Antigen (immunology, metabolism)
• Male
• Middle Aged
• Pancreatic Hormones (immunology, metabolism)
• Pancreatic Neoplasms (chemistry, pathology)
• Phenotype
• Predictive Value of Tests