Korean J Gastroenterol.  2013 Feb;61(2):82-87. 10.4166/kjg.2013.61.2.82.

Prognostic Significance of Ki-67 Expression in Rectal Carcinoid Tumors

• Hong SM
• Kim YS
• Moon JS
• Kim JN
• Oh MK
• Kwon SO
• Jeong SY
• Hong SW
• Kang YK

• KMID: 1775771
• DOI: http://doi.org/10.4166/kjg.2013.61.2.82

Abstract

BACKGROUND/AIMS
Rectal carcinoid tumors can be resected with endoscopy, and it is important to assess their prognostic factors. We evaluated the potential of Ki-67 expression as a prognostic factor in rectal carcinoid tumors.
METHODS
We retrospectively reviewed the medical records of 37 patients with rectal carcinoid tumors who got endoscopic resection from January 2001 to January 2011 at Inje University Seoul Paik Hospital. We analyzed their endoscopic and histologic findings, Ki-67 expression, clinical outcome, and prognosis.
RESULTS
The mean age (+/-SD) of the patients was 56.3+/-10.7 years, and the male : female ratio was 3.6:1. The mean tumor size was 0.5+/-0.4 cm, 33 patients showed grade 1 tumors (89.2%) and the average Ki-67 expression was 0.7+/-1.2%. Thirty five patients underwent endoscopic mucosal resection, and two required endoscopic submucosal dissection. Eight patients had positive margins after resection, but no cases of lymphovascular invasion were identified. The median follow-up duration was 21.4+/-25.4 months, and no recurrences were observed.
CONCLUSIONS
In low grade rectal carcinoid tumors which are lack of central depression on colonoscopy, the expression of a molecular marker of malignant potential, Ki-67, was low. Therefore, endoscopic resection seemed to be a safe and effective treatment for these tumors.

Keyword

Rectum; Carcinoid tumor; Ki-67; Endoscopy; Therapeutics

MeSH Terms

Adult
Age Factors
Aged
Carcinoid Tumor/*diagnosis/metabolism/pathology
Colonoscopy
Female
Humans
Immunohistochemistry
Ki-67 Antigen/*metabolism
Male
Middle Aged
Prognosis
Rectal Neoplasms/*diagnosis/metabolism/pathology
Retrospective Studies
Sex Factors
Ki-67 Antigen

Figure

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  Fig. 1. (A) Endoscopic findings. Colonoscopy showed a 0.6 cm sized mild yellowish elevated lesion with intact mucosa at anal verge 7.0 cm site. (B) EUS findings. EUS showed a 0.7×0.6 cm sized hypoechoic lesion in the submucosal layer of the rectum.

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  Fig. 2. Ki-67 staining in tumors resected by endoscopic mucosal resection (×200). On light microscopic examination, moderately uniform, small, round tumor cells with minimal cellular atypia were seen. The arrows indicate Ki-67 labeled nuclei, and the Ki-67 labeling index was 4% in this sample.

Reference

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