Expression Of Ki67,PCNA And Mitotic Index In Ovarian Epithelial Tumors

Expression of Ki67,PCNA and mitotic index in ovarian epithelial tumorsOvarian carcinoma are common and the mortality rates of it are the highest among all the gynecological malignancy.About 60%-90% of malignant ovarian neoplasm is epithelial ovarian cancer(EOC),the over-all 5-year of EOC free actuarial survival rate was 20% to 30%.Those patients without specific symptoms at early stage and effective treatment of advanced ovarian tumors had mostly lost the opportunity detecting at advanced stage.As tumors are regarded as the most severe one in uncontrolled proliferation cellular diseases,information on proliferation should prove useful in evaluating ovarian tumor function and be beneficial to choose chemotherapy.MI,SPF and proliferating cell antigen can be the index of cell proliferation function status. Proliferating cell antigen includes:PCNA and Ki67.Objective:To analyze the expressions of Ki67, PCNA and mitotic index in ovarian epithelial tumors and their relationship with clinical pathological features,prognosis and guide individual therapy.Method:Expressions of Ki67,PCNA protein and mitotic index of tumor tissues from 20 patients with normal ovarian tissues,28 patients with ovarian benign tumors,20 patients with borderline tumo(?) and 109(73 metastatic ovarian cancer) patients with malignant tumors were retrospectively studied by American GBI immunohistochemistry two-step method. The expressions of Ki67,PCNA mRNA detected by in situ hybridization (ISH) respectively, in 37 primary ovarian cancer,14 patients with borderline tumors,11 benign tumors and 12 normal ovarian tissues.The relationship between the expression of Ki67,PCNA and mitotic index in human ovarian tumors,clinical pathologic parameters and prognostic was analyzed.The results were analyzed by statistical package for the social science 13.0(SPSS 13.0).Kaplan Meier analysis was used in univariate analyses for relapse rate, a=0.05 was the level of test.Results:1.The Ki67 mRNA and protein expression and overexpression in malignant tumors,borderline tumors,benign tumors and normal ovarian tissues were 70.3%,56.8%,42.9%,35.7%,27.3%,18.2%, 16.7%,8.3%;59.6%,50.5%,45%,35%,32.1%,21.4%,15.0%, 10%. The expression of Ki67 mRNA and protein in ovarian epithelial tumors was higher (P=0.003; P=0.009; P=0.001; P=0.001).The positive rates and overexpression of PCNA mRNA and protein in malignant tumors,borderline tumors,benign tumors and normal ovarian tissues were 89.2%,75.7%,85.7%,71.4%,81.8%,72.7%,66.7%,58.3%;92.7%,76.1%,90%,70%,89.2%,71.4%,75.0%,50%. The expression and overexpression of PCNA mRNA and prote(?) not coincided with differentiating epithelial ovarian tumors (P=0.327; P=0.718;P=0.123;P=0.125).2.The expression of Ki67 in ovarian epithelial was higher in low differential carcinoma,FIGOâ…¢-â…£stage (P=0.008; P=0.007).The expression of Ki67 protein in serous was high,but in other types:such as malignant mixed Mullerian tumor,transitional cell carcinoma was low or missed (P=0.018),there were no significant differences in other clinicopathological factors.The high expression of PCNA was not coincided with histological grading,clinical stage and histological types (P=0.447; P=0.763; P=0.657).There were 72 patients with high mitotic index(66.1%).The high expression of mitotic index coincided with histological grading and clinical stage,but not with histological types (P=0.002; P=0.040).3.The combined overexpression of Ki67and high mitotic index in 57 patients showed significantly statistical difference between not coexpression of Ki67 and high MI in histological grading,clinical stage and histological types (P=0.018; P=0.001; P=0.020).4.In 73 metastatic ovarian cancer:the expression of Ki67, PCNA protein and high MI in primary ovarian cancer was Ki67 58.9%,PCNA 91.8%,high MI 61.6%,and metastatic ovarian cancer(peritoneum,epiploon) was Ki67 41.4%,PCNA 74%,high MI 38.4%(P=0.031; P=0.004; P=0.005).The positive intensity of Ki67 protein expression in primary ovarian cancer was significantly higher than metastatic ovarian cancers(P=0.040).There was no significant difference in positive intensity of PCNA between primary and metastatic ovarian cancers (P=0.514).5.According to the situation of patients recurrence make Kaplan-Meier cure and Log-Rank test proved higher relapse rate in Ki67 protein and high MI positive patients than the negative ones(P=0.030;P=0.001).PCNA expression and relapse rate showed no correlation(P=0.245).Conclusions:The detect of Ki67 and mitotic index can be the biomolecular markers for predicting ovarian epithelial tumors malignant and proliferaive degrees, PCNA can not be a valuable biomarkers in disting benign and malinant ovarian tumor,proiliferation and predicting the outcomes.