Published in Cancer Detection and Prevention 2001; 25(2):210-215.

Ki-67: A Proliferative Marker that May Predict Pulmonary Metastases and Mortality of Primary Osteosarcoma

Norma A. Hernández-Rodríguez, MDa, Elma Correa, MDb, Rita Sotelo, MDc, Adriana Contreras-Paredes, MDa, Celedonio Gomez-Ruiz, MDd, Leon Green, MDb, and Alejandro Mohar, MDe

aDivisión de Investigación Clinica, bServicio de Neumología, cDepartamento de Citopatologia, dLaboratorio de Inmunohistoquímica, and eSubdirección de Investigación, Instituto Nacional de Cancerología, Mexico City, Mexico

Address all correspondence and reprint requests to: Dr. Norma A. Hernández-Rodríguez, School of Biomedical Sciences and Institute of Cell Signalling (ICS), University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom.

ABSTRACT: Alterations in Ki-67 activity have been associated with tumor progression and poor outcome in cancer patients. This study was undertaken to identify the potential of this proliferative marker as a predictor of pulmonary metastases (PM) and mortality in osteosarcoma patients. In 38 patients with tissue available for immunohistochemical analysis, overexpression of Ki-67 was assessed. Chi-square and log rank tests were used to determine differences between proportions of the marker with PM and mortality and survival distributions respectively. P values equal or less than .05 were considered statistically significant. The median follow up of this case series was 28 months. Eighteen (47.4%) of 38 patients developed PM, and 17 (44%) overexpressed Ki-67. We found a high frequency of PM (15 of 17) among those cases that overexpressed Ki-67. This relationship was significant (P = .000006) when compared to the rest of the group. We also found a statistically significant correlation between patients with positive and negative Ki-67 scores and higher and lower mortality (P = .000962). These findings suggest that Ki-67 overexpression could be used as a prognostic molecular marker for the development of PM in osteosarcoma patients.

KEY WORDS: Ki-67, proliferative marker, pulmonary metastasis, osteosarcoma.