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Prognostic Significance of Ki-67 and p53 Immunoreactivity in Cutaneous Squamous Cell Carcinomas

Mansoor, Atiya M.D.; McKee, Phillip H. M.D.; Simpson, Julie A. M.D.; McGuire, Brigid M.D.; Hobbs, Carl M.D.

The American Journal of Dermatopathology: August 1996 - Volume 18 - Issue 4 - p 351-357

In this retrospective study we have investigated the expression of Ki-67 and p53 in 175 random cases of cutaneous squamous cell carcinomas by using the monoclonal antibodies MIB-1 and DO-1, respectively. The expression of these antibodies was compared with various histological parameters of prognostic significance. The staining results were also compared with the clinical outcome of the patients. MIB-1 and DO-1 staining showed statistically significant correlation with histopathological grade of the tumor (p < 0.0001 and p = 0.0016, respectively). The degree of immunolabelling of these antibodies also showed significant correlation with tumor depth and tumor thickness (MIB-1 thickness p = 0.02 and depth p = 0.026, and DO-1 thickness p = 0.014 and depth p = 0.005). The majority of the squamous cell carcinomas in our series were Clark's level IV, which therefore did not correlate with the extent of immunoreactivity (MIB-1, p = 0.098; and DO-1, p = 0.885). Mean length of clinical follow-up was 5.2 years. Aggressive tumor behaviour was seen in 17 patients (10.6%) with 6.9% and 3.4% local recurrences and nodal metastasis respectively. A total of 89.4% patients remained disease-free following their definitive surgical treatment. Vulval skin represented the commonest site associated with unfavourable clinical outcome (five of 17 cases). A large number of squamous cell carcinomas in this poor prognosis group showed a high prevalence of immunoreactivity of the antibodies but this did not achieve any statistical significance. We conclude that Ki-67 and p53 expression in cutaneous squamous carcinoma is not an independent predictor of prognosis.

From the Division of Histopathology (A.M., P.H.M., B.M.) and Department of Public Health Medicine (J.A.S.), UMDS, St Thomas' Campus; and Department of Experimental Pathology (C.H.), UMDS, Guy's Campus, London, England. Senior Lecturer and Consultant (P.H.M.).

Address correspondence and reprint requests to Dr P.H. McKee, Department of Histopathology, St Thomas' Hospital, London SE1 7EH, U.K.

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