Prognostic Utility of the Ki-67 Labeling Index in Follicular Thyroid Tumors: a 20-Year Experience from a Tertiary Thyroid Center

• DOI: 10.1007/s12022-022-09714-4
• Publication Date: 2022-03-19T06:02:51Z
• Authors: L. Samuel Hellgren; Adam Stenman; Johan O. Paulsson; Anders Höög; Catharina Larsson; Jan Zedenius; C. Christofer Juhlin
• Keywords: 0301 basic medicine; 03 medical and health sciences; Ki-67 Antigen; Adenocarcinoma, Follicular; Humans; Thyroid Neoplasms; Prognosis; Article; 3. Good health

Follicular thyroid tumors pose a diagnostic challenge on the preoperative level, as discrimination between follicular carcinoma (FTC) and adenoma (FTA) demands careful histopathological investigation. Moreover, prognostication of FTCs is mostly based tumor size extent invasive properties, while immunohistochemical markers pinpointing high-risk cases are lacking. We have routinely established Ki-67 labeling index for since 1999. To assess potential value an adjunct tool to (1) correctly separate from FTAs (2) help identify poor-prognosis FTCs, we collected clinical data 818 with histological in routine practice (516 FTAs, 252 50 uncertain malignant (FT-UMPs)). The was higher (mean 5.8%) than 2.6%) (P < 0.001), receiver operating characteristic curve analysis revealed cut-off 4% FTC FTA sensitivity specificity 65% 83%, respectively. Similarly, above found that later metastasized clinically indolent 80% 48%, constituted independent predictor future metastases/recurrence death disease, > reliable prognostic marker within individual pT staging groups. conclude potentially valuable implementation assessments could be beneficial if reproduced international series.