Assessment of proliferative activity in carcinomas of the human alimentary tract by Ki‐67 immunostaining

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Abstract
The monoclonal antibody (MAb) Ki‐67, which is directed against a proliferation‐associated nuclear antigen, was used to measure tumor proliferation in 165 carcinomas of the esophagus, stomach, colon and rectum with an indirect immunoperoxidase technique. The percentage of Ki‐67‐positive tumor cells (Ki‐67 index) was evaluated with the point‐counting method. The Ki‐67 index in gastric cancers (mean, 24.8%; standard deviation, 11.1%) was significantly lower than in tumors of the esophagus (35.7 ± 12.6%), colon (37.6 ± 15.2%), and rectum (34.3 ± 16.4%). A wide range of the Ki‐67 index (5.9‐75.3%) could be observed within the various tumor types. In recurrent colorectal carcinomas, the Ki‐67 index significantly increased to 51.9%. The Ki‐67 index was independent of pathologic (e.g., TNM‐stage, grading, tumor volume, tumor site) and clinical variables (age and gender of the patients). A marked heterogeneity of Ki‐67 expression within different tumor stages was noted. Statistically significant regional variations in tumor proliferation existed between different areas within the same tumor.

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