Ki-67 and p53 immunohistochemical expression in prostate carcinoma: An experience from a tertiary care centre of North India.

Abstract

Background Carcinoma of the prostate poses a considerable medical and public health challenge in many parts of the world. Despite advances in screening and multimodal management of this disease, overall survival remains poor. The need to identify tumor markers as prognostic indicators and as targets for new therapeutic strategies, still remains a major challenge in prostate carcinoma research. Methods: The study was conducted on 50 histopathologically proven cases of prostate carcinoma received in the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. The aim was to evaluate the immunohistochemical expression of  Ki-67 antigen and p53 protein in prostate carcinoma and to find their correlation with other clinicopathological parameters. The results obtained were tabulated and statistically analyzed. A p value less than 0.05 was considered statistically significant. Results Maximum cases (74%) were observed in the age group of 61 – 80 years. The most common pattern of Gleason grade seen was( 5+4) constituting 32% of the  total cases. The most common Gleason score seen was 7 - 8 constituting 48% of the total cases. The Ki-67 positivity was observed in 80% of  cases with percentage positive cells varying from 3-84% with moderate and strong staining intensity. It was observed that with increase in the grade and score the number of cases showing positivity also increased but no statistical significance was seen with the same. The p53 positivity was observed in 58% of cases with percentage positive cells varying from 5-80% with mild, moderate and strong staining intensity. It was observed that with increase in the grade and score the number of cases showing positivity also increased but no statistical significance was seen with the same. 24 cases(48.0%) were positive for both Ki-67 and p53. Of the 24 cases of intermediate grade tumors positivity for both Ki-67and p53 was noted in 11 cases (45.8%) but no statistical significance was observed with increase in grade and score. Conclusion The present study highlights that the immunohistochemical expression of  Ki-67 and  p53 should be assessed  in all the cases of prostate carcinoma as these markers allow identification of  tumors with a higher rate of cell growth. They also permit development of prognostic factors as their expression increases with increase in the grade and these patients can be benefited with the appropriate targeted treatment leading to increase in the survival time.