Prognostic value of Ki 67 antigen in bilharzial urinary bladder carcinoma: an immunohistochemical analysis

ABSTRACT

The aim of this study was to investigate the role of tumour proliferation marker [ki-67 antigen] and its relation to the traditional prognostic indicators in patients with urinary bladder cancer who underwent radical cystectomy. Samples were obtained from 46 patients [39 men and 7 women, mean age 47.7 years, range 25-73]. All samples [32 SCC, 12 TCC and 2 adenocarcinoma] were associated with bilharzial infestation. Ki-67 was assessed using an immunohistochemical approach. The relation between Ki-67 expression and prognostic variables [grade, stage, age and type] was investigated by Chi-square, analysis of variance and Kruskal Wallis non-parametric test. The frequency of high Ki-67 expression [> 10%] increased with grade and stage. There was a strong overall correlation with grade [p=0.000] and stage [p=0.005] respectively but not with age. Tumour histological type SCC significantly correlated with grade and stage [p= 0.0001 and 0.001], TCC correlates with grade [0.01] but not stage, while TCC has a higher Ki-67 index. These results suggest that immunohistochemical analysis of Ki-67 is a useful prognostic indicator in patients with Schistosoma associated urinary bladder cancer. Abbreviation SCC, squamous cell carcinoma; TCC, transitional cell carcinoma