Role of Ki 67 in Normal Endometrium, Endometrial Hyperplasia and Endometrial Carcinoma: A Comparative Study

Abstract

Introduction: Endometrial carcinoma is the 4th most common malignancy inwomen and its incidence is increasing both in developed and developing countries. The updated WHO classification classifies  endometrialhyperplasiait as hyperplasia without atypia and atypical endometrial hyperplasia. Atypical hyperplasia has a high risk of progression to endometrial carcinoma. Ki 67 is a well-known marker of cell proliferation and its expression is upregulated in many cancers. Development of endometrial hyperplastic lesions and its transformation to endometrial carcinoma may be strongly influenced by cell proliferation markers.

Objectives: The aim of this study was to assess and compare staining of Ki 67 in the normal, hyperplastic and carcinoma endometrium which could help in understanding its role in progression to carcinoma endometrium.

Methods: The study was conducted from  January 2017 to June 2018. 50 cases were included, out of which 15 cases were of normal endometrium, 10 cases were of endometrial hyperplasia without atypia, 10 cases were of atypical hyperplasia and 15 cases wereof endometrial adenocarcinoma. Immunohistochemical staining with Ki-67 was performed and the results were analyzed based on percentage positivity of the cells.

Results: Among 50 cases, 84% (n=42) showed positive Ki-67 staining. Ki 67 expression increased as the lesions progressed from normal endometrium, endometrial hyperplasia to endometrial carcinoma, which was found to be statistically significant. ( p=0.000122).

Conclusions: Our findings, suggest the significance of endometrial hyperplasia as a precancerous lesion. Ki 67 may have a prognostic role in patients diagnosed as endometrial hyperplasia, and carcinoma.