Immunohistochemistry Expression of Ki-67 in Nodular Hyperplasia,

Prostatic Intraepithelial Neoplasia and Adenocarcinoma Prostate

Lidya Imelda Laksmi, T. Ibnu Alferraly

Department of Anatomical Pathology, Universitas Sumatera Utara, Medan, Indonesia

Keywords: immunohistochemistry Ki-67, Nodular Hyperplasia, Prostatic Intraepithelial Neoplasia, Prostate

Adenocarcinoma

Abstract: Immunohistochemistry Ki67 is a marker of cell proliferation. This descriptive study was performed in the

Department of Anatomical Pathology Universitas Sumatera Utara, Medan, Indonesia. A total of 86 paraffin

blocks prepared from transurethral resection of the prostate (TUR-P) were collected in this study. The

specimens divided as three lesions; nodular hyperplasia, prostatic intraepithelial neoplasia (PIN) and

adenocarcinoma prostate. In this study a total of 86 specimens from TUR-P, we divided them using IHK

p63 as three lesions; (1). Nodular hyperplasia prostate, frequency 31 (36%), (2). Prostatic intraepithelial

neoplasia 17 (19,8%), and (3). Adenocarcinoma prostate 38 (44,2%). Our results show the expression Ki67

in nodular hyperplasia is (9.65 ± 11.577), median: 5; Prostatic intraepithelial neoplasia (14.71 ± 14.67),

median 7 and adenocarcinoma prostate (57.53 ± 27.57), median 50. This study concluded that in prostate

tissue examination, immunohistochemistry expression of Ki67 are different in nodular hyperplasia, PIN and

prostate adenocarcinoma. Whereas the expression of Ki67 is higher in adenocarcinoma than PIN and

nodular hyperplasia

1 INTRODUCTION

In 1980 Ki-67 antigen was identified by Scholzer

and Gerdes. This antigen was encoded with two

protein isoform which weight are 345 and 395 kDa.

Ki67 is achive in G1, S, G2 and M, but decrease

sharply in anaphase and telophase, but inactive in

phase G0. It has ~1-1,5 h half-life. Ki-67 expression

could be used as a marker of tumor aggressiveness

since its expression is related to proliferative activity

of intrinsic cells of malignant tumors. Several

studies have showed its potential as prognostic

marker in breast, soft tissue, lung, prostate, cervix

and central nervous system. The St. Gallen

consensus panel has recommended Ki67 as a marker

to differentiate luminal A and luminal B subgroups

of IBC. At 2015 St Gallen Breast Cancer

Conference, define 20-29% as cut-off value of Ki-67

to differentiate luminal B-like subgroup.

A number of studies, using pKi67 as a diagnostic

tool, prognostic tool and a potential target for cancer

therapy. Ki67 is frequently used as an indicator of

cell proliferation. A number of diagnostic

applications for pKi67 have been described, where

Ki67 was significantly more highly expressed in

malignant than in normal tissues. pKi67 also tended

to increase with decreasing tissue differentiation,

and it was correlated with the presence of occult

metastasis and the clinical stage of tumors. Several

studies have shown correlation between proliferative

markers and tumor grade to determine prognostic

factor of the disease.

The purpose of this study is knowing the

expression of Ki67 in nodular hyperplasia, prostatic

intraepithelial neoplasia (PIN) and prostate

adenocarcinoma.

2 MATERIAL AND METHODS

This descriptive study was performed in the

Department of Anatomical Pathology Universitas

Sumatera Utara, Medan, Indonesia. A total of 86

paraffin blocks prepared from transurethral resection

of the prostate (TUR-P) were collected in this study.

These specimens divided as three lesions; nodular

884

Laksmi, L. and Alferraly, T.

Immunohistochemistry Expression of Ki-67 in Nodular Hyperplasia, Prostatic Intraepithelial Neoplasia and Adenocarcinoma Prostate.

DOI: 10.5220/0010098308840886

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

884-886

ISBN: 978-989-758-449-7

hyperplasia, prostatic intraepithelial neoplasia and

adenocarcinoma prostate.

Each paraffin block was recut into serial section

and stained by Hematoxylin and Eosin,

immunohistochemistry p63 and Ki67. The block

paraffin was section into 2 to 3 µ, then prepared and

stained with p63 immunohistochemistry to make

sure that the lesion was diagnosed as PIN or

malignant lesion. We used the REAL EnVision

method to p63 immunohistochemistry staining with

1:100 dilution and Ki67 1:200. The interpretation of

p63 used, continuous expression as a benign lesion,

discontinuous as a premalignant lesion (PIN) and no

expression from basal cell glandular as a malignant

lesion (adenocarcinoma). The positive control was

tonsil tissue for Ki67 and positive staining was

identified by the presence of brown nuclear stain

(DAB) in 100 tumor cells considered as positive

staining.

Eligibility criteria: (1). Inclusion criteria, block

paraffin from TUR-P specimens with ≥ 100 cells of

population tumor; (2). Exclusion criteria is

inadequate populations of tumor cells and poorly

preserved prostatic specimens were excluded.

3 RESULTS

In this present study a total of 86 specimens from

TUR-P. We divided them using IHK p63 as three

lesions; (1). Nodular hyperplasia prostate, frequency

31 (36%), (2). PIN 17 (19,8%), and (3).

Adenocarcinoma prostate 38 (44,2%). Our results

showed the expression Ki67 in nodular hyperplasia

is (9.65 ± 11.577), median: 5; PIN (14.71 ± 14.67),

median 7 and adenocarcinoma prostate (57.53 ±

27.57), median 50.

4 DISCUSSION

Prostatic carcinoma is one of the most prevalent

types of carcinoma in men. The early diagnosis of

carcinoma can be done by early detection of focus

premalignant lesions of the prostate only from the

histopathology examination. To diagnose benign or

malignant lesions from prostate tissue the one of the

criteria is that we can see intact or discontinue basal

cell layer, whereas in malignant lesions does not

expressed [26,27]. In this study we have done using

IHK p63 to determine nodular hyperplasia, PIN and

adenocarcinoma. Our results showed the expression

of Ki67 is higher in adenocarcinoma prostate, PIN

and nodular hyperplasia.

Ki67 is often used as an indicator of cell

proliferation. Several of diagnostic applications for

pKi67 described that Ki67 was significantly more

highly expressed in malignant than in normal

tissues. Uncontrolled proliferation is a sign of

malignancy and the measurement of Ki67 antigen by

using IHC is the most widely performed assessment

of a tumor’s proliferation potential.

5 CONCLUSIONS

This study concluded that in prostate tissue

examination, immunohistochemistry expression of

Ki67 are different in nodular hyperplasia, PIN and

prostate adenocarcinoma. Whereas the expression of

Ki67 is higher in adenocarcinoma than PIN and

nodular hyperplasia. It means Ki67 may be helpful

in differentiation between nodular hyperplasia, PIN

and prostate adenocarcinoma.

ACKNOWLEDGEMENTS

We acknowledged for research institutions in

Universitas Sumatera Utara Medan Indonesia for

their help to this study.

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