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No6(2) 2019

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DOI 10.37219/2528-8253-2019-6-37
Kovtunenko OV, Tymchuk SM, Shportko BV
Analysis of expression of molecular marker KI-67 in patients with laryngeal cancer for regional metastases and recurrences
Kovtunenko Alexander Vasilievich
State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine»
Professor of the Department of Otolaryngology
Doctor of Medical Sciences
Email: lor@dsma.dp.ua
Orchid ID: https://orcid.org/0000-0002-0562-7684

Tymchuk Sergey Nikolaevich
Municipal enterprise «Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov» Dnipropetrovsk Regional Council
Head of the Department of Otorhinolaryngology No. 2 (oncological)
Doctor of Medical Sciences
Email: sergej_lor@ukr.net
Orchid ID: https://orcid.org/0000-0002-8706-2313

Shportko Bogdan Viktorovich
Municipal enterprise «Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov» Dnipropetrovsk Regional Council
Department of Otorhinolaryngology No. 2 (oncological)
Otolaryngologist
Email: bogdan.shportko@gmail.com
Orchid ID: https://orcid.org/0000-0002-4242-2784

Abstract

Background: Laryngeal cancer is a common localization of squamous cell carcinoma of the head and neck. The main factor influencing the survival of patients is the presence of regional metastases. The malignant degeneration of a cell is always accompanied by disruption of the cell cycle, in particular a sharp increase in proliferative activity. The molecular marker Ki-67 is used to investigate the proliferative activity of tumor cells.
Aim of the study: To study the informative content of immunohistochemical investigation and to determine the expression of the molecular marker Ki-67 in patients with laryngeal cancer, prior to the prediction of regional metastasis and relapse.
Materials and Methods: 70 patients with cancer, stage III-IV (T3-4N0-3M0) clinical group II were under observation. Of these, 39 patients from the main group were with regional laryngeal cancer metastases, and 31 patients in the comparison group – without revealed regional metastases. Patients' age ranged from 33 to 74 years. The average age was 61.9 years. Male patients made up the absolute majority of 99% No = 69. All patients were histologically diagnosed with squamous cell carcinoma. Monoclonal antibodies to Ki67 (TermoScientific, USA) were used as the primary molecular markers. The proliferation index (PI) was rated as low in the range of 0-30% and as high in more than 30% of positive cells with an intranuclear label.
Results: The study of molecular markers Ki-67 showed its expression at 69 [60.2; 77.5]% (Me [25%; 75%]) for the squamous cell laryngeal cancer group, without metastases – 60 [29; 70.5]%, for the group with metastases – 72 [67; 80]% (P <0.001).
In statistical data processing, the AUC value (0.777) was set for Ki-67 for metastasis and showed an increased degree of expression for laryngeal cancer metastasis. Ki-67 has a good diagnostic value and can be used as an additional method for predicting regional laryngeal cancer metastases. However the practical use of this marker as a prognostic one for determining the volume of surgery on the lymphatic structures of the neck requires further investigation.
It should be noted that this study did not reveal the link of Ki-67 AUC (0.588) with the degree of differentiation of laryngeal cancer and its recurrence, but more in-depth study of molecular markers in the future may reveal other patterns of tumor growth and be used in the prognosis and personalization of treatment.
Conclusion: Expression of Ki-67 allowed to accurately predict tumor metastasis. A 1% increase in Ki-67 expression resulted in an 8.3% increase in the chance of tumor metastasis (95% CI - 1.043-1.142), and the age dependence on metastasis is not reliable.
Determination of expression of Ki-67 does not accurately predict the possibility of recurrence of laryngeal cancer (p=0.27; AUC (95% CI) – 0.588 (0.414-0.763)) herewith age dependence of chance of a recurrence was not revealed.

Keywords

laryngeal cancer, metastases, immunohistochemical study, Ki-67.


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