Proliferative Markers of Breast Cancer / 한국유방암학회지

PURPOSE: The mitotic index (MI) and Ki-67 labeling index have been used as cell proliferative markers in the various tumors. Topoisomerase II alpha (Topo II alpha) is also expressed in proliferating cells. The aim of this study was to evaluate the correlations between the MI, Ki-67, and Topo II alpha expression as proliferative markers of breast cancer. METHODS: The cell proliferative activity of 181 breast cancers was measured using MI, Ki-67 labeling index and Topo II alpha expression. The correlation between the measured markers was also analyzed. RESULTS: The MI, Ki-67, and Topo II alpha were significantly correlated with each other(p < 0.000). The MI and Ki-67 labeling index were associated with high histological grade, and absence of hormone receptor (p < 0.000). Topo II alpha expression was correlated with high histological grade (p < 0.000), absence of hormone receptor and HER-2/neu overexpression (p < 0.043). The MI, Ki-67, and Topo II alpha were not associated with any other clinical variables, such as age, tumor size, and lymph node status. CONCLUSION: The three proliferative indices were significantly associated with aggressive features of breast cancer, and significantly correlated with each other.

Analysis of Prognostic Factors in Gastrointestinal Stromal Tumors

PURPOSE: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and are immunohistochemically defined as c-KIT (CD117) positive tumors. This study investigated the behaviors of GISTs of the gastrointestinal tract and determined the prognostic factors associated with GISTs. METHOD: The clinical records of 22 patients, who were diagnosed and underwent surgery for a GIST of the GI tract at Inje university Sanggye Paik hospital from 1998 to 2004, were retrospectively analyzed. The relationship between the disease-free survival rate of the GISTs and several factors including age, gender, mitotic count, tumor site, tumor size, tumor necrosis & hemorrhage, and Ki-67 index was examined. RESULTS: The study group comprised of 13 men and 9 women. The mean age was 57.1 years (31~77 years) at the time of diagnosis. The median follow-up period was 24 months (3~45 months). A complete resection of the tumor was performed in 19 patients. There were lymph node metastases in 1 case. Five out of the 19 patients who had undergone a complete tumor resection showed recurrence (27%). The sites of recurrence were the back (1), liver (1), and abdominal cavity (3). Univariate analysis revealed, the following to be prognostic factors for the disease-free survival of patients with GISTs: high power field mitotic counts of the tumor ( or =5/50; P=0.013), the tumor size ( or =5 cm; P=0.047) and the Ki-67 index ( or =5%; P=0.001). CONCLUSION: The prognostic factors for disease-free survival rate of GISTs were high power field mitotic counts of the tumor, the tumor size and the Ki-67 index. It is recommended that more careful and frequent postoperative follow-up examinations be performed for patients showing the poor prognostic factors.