INDEPENDENT PROGNOSTIC-SIGNIFICANCE OF A NUCLEAR PROLIFERATION ANTIGEN IN DIFFUSE LARGE CELL LYMPHOMAS AS DETERMINED BY THE MONOCLONAL-ANTIBODY KI-67

  • 1 April 1988
    • journal article
    • research article
    • Vol. 71  (4) , 1157-1160
Abstract
To assess the prognostic significance of the growth fraction in diffuse large cell lymphoma (DLCL), we studied 105 DLCL patients with the monoclonal antibody Ki-67 applied to frozen tissue sections. Ki-67 detects a nuclear antigen associated with cell proliferation not found in resting cells. Ki-67 findings and other clinical prognostic factors were correlated with outcome using univariate and multivariate analyses in the proportional hazards model. High proliferative activity, defined as nuclear Ki-67 expression in > 60% of malignant cells (Ki-67 > 60), was found to be a strong predictor of poor survival among these patients (P = .003, log-rank). The 19 patients with Ki-67 > 60% had a median survival of 8 months compared with a median survival of 39 months for the 86 patients with Ki-67 .ltoreq. 60%. Examination of pretreatment clinical variables indicated the patient groups were similar with regard to age, sex, stage, B symptoms, tumor bulk, and lactate dehydrogenase (LDH). Both patient groups received comparable curative intent therapy and showed comparable complete response rate precluding treatment differences as modifying outcome. Multivariate analysis indicated Ki-67 is an independent predictor of survival (multivariate P = .006). Further statistical analysis using only B-cell DLCL patients treated with CHOP (63 patients) indicated that Ki-67 > 60 retained strong prediction of poor outcome (P = .002, log-rank) among this homogeneous group. We conclude that high proliferative activity (Ki-67 > 60) is an independent factor allowing laboratory prediction of probable poor outcome of DLCL.