Ki-67 and p53 immunohistochemical expression in prostate carcinoma: An experience from a tertiary care centre of North India.

  • Harjot Kaur
  • Mohit Paul
  • Mridu Manjari
  • Sonam Sharma
  • Tejinder Singh Bhasin
  • Rahul Mannan
Keywords: Prostate carcinoma, p53, Ki-67, Punjab, Significance

Abstract

Background Carcinoma of the prostate poses a considerable medical and public health challenge in many parts of the world. Despite advances in screening and multimodal management of this disease, overall survival remains poor. The need to identify tumor markers as prognostic indicators and as targets for new therapeutic strategies, still remains a major challenge in prostate carcinoma research.Methods:  The study was conducted on 50 histopathologically proven cases of prostate carcinoma received in the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. The aim was to evaluate the immunohistochemical expression of  Ki-67 antigen and p53 protein in prostate carcinoma and to find their correlation with other clinicopathological parameters. The results obtained were tabulated and statistically analyzed. A p value less than 0.05 was considered statistically significant.Results Maximum cases (74%) were observed in the age group of 61 – 80 years. The most common pattern of Gleason grade seen was( 5+4) constituting 32% of the  total cases. The most common Gleason score seen was 7 - 8 constituting 48% of the total cases. The Ki-67 positivity was observed in 80% of  cases with percentage positive cells varying from 3-84% with moderate and strong staining intensity. It was observed that with increase in the grade and score the number of cases showing positivity also increased but no statistical significance was seen with the same.The p53 positivity was observed in 58% of cases with percentage positive cells varying from 5-80% with mild, moderate and strong staining intensity. It was observed that with increase in the grade and score the number of cases showing positivity also increased but no statistical significance was seen with the same. 24 cases(48.0%) were positive for both Ki-67 and p53. Of the 24 cases of intermediate grade tumors positivity for both Ki-67and p53 was noted in 11 cases (45.8%) but no statistical significance was observed with increase in grade and score.Conclusion The present study highlights that the immunohistochemical expression of  Ki-67 and  p53 should be assessed  in all the cases of prostate carcinoma as these markers allow identification of  tumors with a higher rate of cell growth. They also permit development of prognostic factors as their expression increases with increase in the grade and these patients can be benefited with the appropriate targeted treatment leading to increase in the survival time.

References

1. Zhong WD, Li JL, He HC. Study on the expression of BPH and prostate cancer related genes using real-time quantitative RT-PCR. Chin J Urol 2005;26:615-61.
2. Srigley JR. Benign mimickers of prostatic adenocarcinoma. Mod Pathol 2004;17:328-48.
3. Humphrey PA. Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol 2004;17:292-306.
4. Radiae S. Prostate cancer molecular staging. State of –the – Art in prostate and breast cancer treatment.Euro Sch Oncol 2002;50:101-4.
5. Stricker HJ, Jay JK, Linden MD, Tamboli P, Amin MB. Determining prognosis of clinically localized prostate cancer by immunohistochemical detection of mutant p53.Urology1996;47:366-9.
6. Thomas DJ, Robinson M, King P, Hasan T, Charlton R, Martin J. p53 expression and clinical outcome in prostate cancer.Br J Urol 1993;72:778-81.
7. Shurbaji MS, Kalbfleisch JH, Thurmond TS. Immunohistochemical detection of p53 protein as a prognostic indicator in prostate cancer.HumPathol1995;26:106-9.
8. Guillaud P, duManoir S, Seigneurin D. Quantification and topographical description of KI-67 antibody labelling during the cell cycle of normal fibroblastic (MRC-5) and mammary tumor celllines(MCF-7). Anal Cell Pathol 1989;12:568-72.
9. Gerdes J, Li L, Schlueter C, Duchrow M, Wohlenberg C, Gerlach C. Immunological and molecular biologic characterisation of the cell proliferation-associated nuclear antigen that is defined by monoclonal antibody Ki-67.Am J Pathol 1991;138:867-73.
10. Rajeswari K, Meenakshisundaram K, Anushuya G, Rajalaxmi J. Ki 67 as a prognostic marker in comparison with Gleason’s grading system in prostatic carcinoma. Ind J Pathol Oncol 2016; 3: 92-5.
11. Bettencourt MC, Bauer JJ, Sesterhenn IA, Mostofi FK, McLeod DG, Moul JW.Ki-67 expression is a prognostic marker of prostate cancer recurrence after radical prostatectomy. J Urol1996;156:1064-8.
12. Borce M, Stausbat-Gron B, Overgaard J. P53 accumulation associated with bcl-2, the proliferation marker MIB-1 and survival in patients with prostate cancer subjected to watchful waiting. J Urol 2000;164:716-21.
13. Lumachi F, Marino E, Lacobone M. Immunohistochemical markers PCNA-LI and Ki-67, and DNA index in patients with Parathyroid carcinoma. Oral Presentations 2006;26:316-8.
14. Carter HB, Epstein JI, Partin AW. Influence of age and prostate-specific antigen on the chance of curable prostate cancer among men with nonpalpable disease. Urology 1999 ;53(1):126-30.
15. Malati T, Kumari GR, Reddy PVLN, Prakash BS. Prostate specific antigen in patients of benign prostate hyperplasia and carcinoma prostate. Indian J Clin Biochem 2006;21:34-40.
16. Petrescu A, Marzan L, Codreanu O, Niculescu L. Immunohistochemical detection of p53 protein as a prognostic indicator in prostate carcinoma. Rom J Morphol Embryol 2006;47:143-6.
17. Madani SH, Ameli S, Khazaei S, Kanani M, Izadi B. Frequency of Ki-67(MIB-1) and P53 expressions among patients with prostate cancer. Indian J Pathol Microbiol 2011;54:688-91.
18. Moul JW, Bettencourt MC, Sesterhenn IA, Mostofi FK, McLeod DG, Srivastava S, et al. Protein expression of p53, bcl-2, and KI-67 (MIB-1) as prognostic biomarkers in patients with surgically treated, clinically localized prostate cancer. Surgery 1996;120:159-66.
19. Sasor A, Wagrowska-Danilewicz M, Danilewicz M. Ki 67 antigen and p53 protein expression in benign and malignant prostatic lesions. Immunohistochemical quantitative study. Pol J Pathol 2000;51:31-6.
20. Yaman O, Ozdiler E, Orhan D, Sak SD, Baltaci S, Tulunay O, et al. Immunohistochemical determination of p53 protein in prostatic cancer and prostatic intraepithelial neoplasms. Urol Int 1997;58:199-202.
21. Kallakury BV, Figge J, Ross JS, Fisher HA, Figge HL, Jennings TA. Association of p53 immunoreactivity with high gleason tumor grade in prostatic adenocarcinoma. Hum Pathol 1994;25:92-7.
22. Thompson SJ, Mellon K, Charlton RG, Marsh C. p-53 and Ki-67 immunoreactivity in human prostate cancer and benign hyperplasia. Br J Urol 1992;69:609-13.
23. Zhong W, Peng J, He H, Wu D, Han Z, Bi X, et al. Ki-67 and PCNA expression in prostate cancer and benign prostatic hyperplasia. Clin Invest Med2008;31:E8-E15.
24. Makarewicz R, Zyromska A, Andrusewicz H. Comparative analysis of biological profiles of benign prostate hyperplasia and prostate cancer as potential diagnostic, prognostic and predictive indicators. Folia Histochemica Et Cytobiologica 2011;49:452-7.
25. Sulik M, Maruszak K, Puchalska J, Misiukiewicz M. Expression of KI-67 as a proliferation marker in prostate cancer.Pol Ann Med 2011;18:12-9.
26. Munoz E, Gomez F, Paz JI, Casado I, Silva JM, Corcuera MT, et al.Ki-67 immunolabeling in pre-malignant lesions and carcinoma of the prostate.Histological correlation and prognostic evaluation. Eur J Histochem 2003;47:123-8.
27. Verma R, Gupta V, Singh J, et al. Significance of P53 and ki-67 expression in prostate cancer. Urol Ann 2015; 7(4): 488-93.
28. Wang Y, Zhang YX, Kong CZ, Zhang Z, Zhu YU. Loss of P53 facilitates invasion and metastasis of prostate cancer cells. Molecular and Cellular Biochemistry 2013; 384: 121-7.
29. Rashed HE, Kateb MI, Ragab AA, Shaker SS. Evaluation of minimal prostate cancer in needle biopsy specimens using AMACR (p504s), p63 and Ki-67. Life Sci 2012;9:12–21.
Published
2016-12-12
Section
Original Article

Most read articles by the same author(s)

1 2 > >>