Regular Article

British Journal of Cancer (1999) 81, 747–751. doi:10.1038/sj.bjc.6690758 www.bjcancer.com
Published online 24 September 1999

Both cell proliferation and apoptosis significantly predict shortened disease-free survival in hepatocellular carcinoma

Y Ito1,2, N Matsuura2,1, M Sakon1, T Takeda1, K Umeshita1, H Nagano1, S Nakamori1, K Dono1, M Tsujimoto3, M Nakahara4, K Nakao4 and M Monden1

  1. 1Department of Surgery II, Osaka University Medical School, Osaka, Japan
  2. 2Department of Pathology, School of Allied Health Science, Faculty of Medicine, Osaka University, Osaka, Japan
  3. 3Departments of Pathology, Osaka Police Hospital, Osaka, Japan
  4. 4Departments of Surgery, Osaka Police Hospital, Osaka, Japan

Correspondence: N Matsuura, Department of Pathology, Allied Health Science, Osaka University Faculty of Medicine, 1–7, Yamadaoka, Suita, Osaka 565, Japan

Received 20 October 1998; Revised 9 February 1999; Accepted 16 February 1999.

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Abstract

In this study, we investigated the proliferating cell index by the percentage of Ki-67 expressing cells (Ki-67 LI) and the apoptotic index (AI) by the number of morphologically apoptotic cells per 1000 carcinoma cells in haematoxylin and eosin sections of 76 hepatocellular carcinomas (HCC). Both indices showed excellent correlation with each other (P < 0.0001) and were significantly higher in cases of poor differentiation, of advanced stages, with portal invasion and with intrahepatic metastasis. Furthermore, cases with higher Ki-67 LI or higher AI displayed poor outcomes for disease-free survival (P = 0.0001 and P = 0.0005) by univariate analysis. By multivariate analysis, both indices could be regarded as independent prognostic factors. These results strongly suggest that Ki-67 LI and AI have very similar clinical significance, reflecting the existence of biologically aggressive phenotypes and poor disease-free survival rate in HCC.

Keywords:

Ki-67, apoptosis, immunohistochemistry, hepatocellular carcinoma, prognostic factor

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