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Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 463 - 464
1 Jul 2010
Vishnevskaya Y Martynkov D Charatishvili T Bohyan B Aliev M
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Analysis of correlation of proliferation index Ki67 with grade and recurrence type of soft tissue sarcomas.

We reviewed 34 patients treated in RCRC RAMS. 53% patients were female, 47% – male. Adult patients – 97%, children – 3%. Soft tissue tumors localized on lower extremities in 47% cases (hip, shank), on upper extremities in 20% cases (shoulder, forearm, hand), on trunk in 24% cases, on head and neck in 9% patients. Histological subtypes were monophase synovial sarcoma – 32%, malignant fibrous histiocytoma – 23%, liposarcoma – 18%, malignant shwannoma – 6%, and other types in isolated instances. Synovial sarcoma more often observed in young and middle age women, malignant fibrous histiocytoma – in old men, liposarcoma – equally often in middle and old men and women. We observed soft tissue sarcoma grade 2 (FNCLCC) more frequently. Local recurrence development in 35% cases, number of recurrences was from 1 to 6. Distant metastases were in 8 patients (in lungs, lymph nodes, bones). We used monoclonal antibody Ki67 (clone MIB-1). Proliferation index Ki67 evaluated in the following way: low level – < 25% of tumor cells, middle level – 25–50%, and high level – > 50% of tumor cells.

Proliferation activity Ki67 increase in cases with high grade soft tissue sarcoma (in grade 1 tumors – low and middle proliferation activity, in grade 2 tumors – middle and high proliferation activity, in grade 3 tumors – only high proliferation activity).

Proliferation activity Ki67 increase in recurrent tumors (2–3 times more in comparison with primary tumors).

In cases with low level of proliferation index Ki67 were observed more number of local recurrences (> 3), and long interval to distant metastases. If level of Ki67 was high, time interval to local recurrence was short, number of local recurrences < 3, lethal outcome occurred often.