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Ki-67 index as a predictor of vestibular schwannoma regrowth or recurrence

Published online by Cambridge University Press:  15 April 2019

J Prueter ,
D Norvell  and
D Backous
J Prueter*
Affiliation:
Department of Hearing and Skull Base Surgery, Swedish Hospital, Swedish Neuroscience Institute, Washington, USA
D Norvell
Affiliation:
Spectrum Research, Steilacoom, Washington, USA
D Backous
Affiliation:
Puget Sound ENT, Proliance Surgeons, Edmonds, Washington, USA
*
Author for correspondence: Dr James Prueter, Swedish Neuroscience Institute, 21911 76th Avenue W, Suite 211, Edmonds, WA 98026, USA E-mail: [email protected] Fax: +1 425 670 6718
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Abstract

Background

Ki-67 is a monoclonal antibody that provides a means of evaluating the growth fraction of normal and neoplastic human cell populations. A Ki-67 index of less than 3 per cent is expected for a typical schwannoma. Vestibular schwannomas with an index of greater than 3 per cent are presumed to be actively proliferating and pose a theoretically higher risk for regrowth or recurrence.

Methods

A retrospective chart review was conducted. Ki-67 staining was performed and specimens were divided into two groups according to Ki-67 activity: less than 3 per cent (low index), and 3 per cent or greater (elevated index).

Results

Eight patients (53.3 per cent) with elevated Ki-67 had recurrence or regrowth, versus five (8.5 per cent) in the low Ki-67 group. Among the 13 patients with recurrence or regrowth, the average Ki-67 value was 4.3 per cent. Among the 61 patients without recurrence or regrowth, the average Ki-67 value was 1.0 per cent.

Conclusion

The Ki-67 labelling index reliably identifies vestibular schwannomas with an elevated potential for recurrence or regrowth in subtotal or total resection cases. In patients with a Ki-67 index greater than 3 per cent, more frequent clinical examination and radiological follow up are recommended.

Keywords

Schwannoma, VestibularRecurrenceNeuroma, Acoustic
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 3 , March 2019 , pp. 205 - 207
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr J Prueter takes responsibility for the integrity of the content of the paper

Presented as a poster at the Combined Otolaryngology Spring Meeting, 18–22 April 2018, National Harbor, Maryland, USA.

References

1Henschen, F, Lundbourg, T. The relationship between the clinical course and the morphologic picture in acoustic tumors. Acta Otolaryngol Suppl (Stockh) 1954;116:121–6Google Scholar
2Olivecrona, H. Analysis of results of complete and partial removal of acoustic neuromas. J Neurol Neurosurg Psychiatry 1950;13:271–2Google Scholar
3Charabi, S, Engel, P, Jacobsen, GK. Growth rate of acoustic neuroma expressed by Ki-67 nuclear antigen versus symptom duration. Ann Otol Rhinol Laryngol 1993;102:805–9Google Scholar
4Rutka, JA, Davidson, G. Controversies in the histopathology of acoustic neuromas and their biologic behavior. In: Tos, M, Thomsen, J. Acoustic Neuroma: Proceedings of the First International Conference on Acoustic Neuroma, Copenhagen, Denmark, August 25–29, 1991. New York: Kugler Publications, 1992;199–202Google Scholar
5Morris, JH. The nervous system. In: Cotran, RS, Kumar, V, Robbins, SL, eds. Robbins’ Pathologic Basis of Disease, 4th edn. Philadelphia: WB Saunders, 1989;1445–6Google Scholar
6Gerdes, J, Lemke, H, Baisch, H, Wacker, HH. Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody Ki-67. J Immunol 1984;133:1710–15Google Scholar
7Baserga, R. The cell cycle. N Engl J Med 1981;304:453–9Google Scholar
8McKeever, PE, Venneti, S. Immunohistology of the nervous system. In: Dabbs, DJ, ed. Diagnostic Immunohistochemistry: Theranostic and Genomic Applications. Philadelphia: Elsevier, 2019;772–845Google Scholar
9Lesser, THJ, Janzer, RC, Kleihues, P, Fisch, U. Clinical growth rate of acoustic schwannomas: correlation with growth fraction as defined by monoclonal antibody Ki-67. Skull Base Surg 1991;1:11–15Google Scholar
10Bedavanija, A, Brieger, J, Lehr, HA, Maurer, J, Mann, WJ. Association of proliferative activity and size in acoustic neuroma: implications for timing of surgery. J Neurosurg 2003;98:807–11Google Scholar
11Szeremeta, W, Monsell, E, Rock, J, Caccamo, D. Proliferation indices of vestibular schwannomas by Ki-67 and proliferating cell nuclear antigen. Am J Otol 1995;16:616–19Google Scholar
12Light, JP, Roland, T, Fishman, A, Miller, D, Cohen, N. Atypical and low grade malignant vestibular schwannomas: clinical implications of proliferative activity. Otol Neurotol 2001;22:922–7Google Scholar
13Yokoyama, M, Matsudam, M, Nakasu, S, Nakajima, M, Handa, J. Clinical significance of Ki-67 staining index in acoustic neuroma. Neurol Med Chir (Tokyo) 1996;36:698–703Google Scholar
14Tsanaclis, AM. The cycling pool of cells within human brain tumors: in situ cytokinetics using the monoclonal antibody Ki-67. Can J Neurol Sci 1991;18:12–17Google Scholar
15Paek, K, Kim, SH, Song, SH, Choi, SW. Clinical significance of Ki-67 labeling in pituitary macroadenoma. J Korean Med Sci 2005;20:489–94Google Scholar
16Chen, Z, Prasad, SC, Di Lella, F. The behavior of residual tumors and facial nerve outcomes after incomplete excision of vestibular schwannomas. J Neurosurg 2014;120:1278–87Google Scholar
17Bloch, DC, Oghalai, JS, Jackler, RK. The fate of the tumor remnant after less-than-complete acoustic neuroma resection. Otolaryngol Head Neck Surg 2004;130:104–12Google Scholar
18Fukuda, M, Oishi, M, Hiraishi, T. Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection. J Neurosurg 2011;114:1224–31Google Scholar
19Schwartz, MS, Kari, E, Strickland, BM. Evaluation of the increased use of partial resection of large vestibular schwanommas: facial nerve outcomes and recurrence/regrowth rates. Otol Neurotol 2013;34:1456–64Google Scholar
20Seol, HJ, Kim, CH, Park, CK. Optimal extent of resection in vestibular schwannoma surgery: relationship to recurrence and facial nerve preservation. Neurol Med Chir (Tokyo) 2006;46:176–80Google Scholar
21Vakilian, S, Souhami, L, Melançon, D, Zeitouni, A. Volumetric measurement of vestibular schwannoma tumour growth following partial resection: predictors for recurrence. J Neurol Surg B Skull Base 2012;73:117–20Google Scholar
22Sughrue, ME, Kaur, R, Rutkowski, MJ. Extent of resection and the long-term durability of vestibular schwannoma surgery. J Neurosurg 2011;114:1218–23Google Scholar
23Virk, JS, Tripathi, S, Randhawa, PS. Tumour resection volumes and facial nerve outcomes for vestibular schwannomas. Indian J Otolaryngol Head Neck Surg 2014;66:191–5Google Scholar
24El-Kashlan, HK, Zeitoun, H, Arts, HA. Recurrence of acoustic neuroma after incomplete resection. Am J Otol 2000;21:389–92Google Scholar
25Kazimierz, N, Vaneecloo, FM, Lecomte, MH, Lejeune, JP, Lemaitre, L, Skarzyński, H et al. Correlation between Ki-67 index and some clinical aspects of acoustic neuromas (vestibular schwannomas). Otolaryngol Head Neck Surg 2000;123:779–83Google Scholar