Supplementary Files
Keywords
Cell Proliferation
Immunohistochemistry
Ki-67 Antigen
Mouth Neoplasms
Neoplasm Grading
Tumor Cell Malignant
How to Cite
Abstract
Objective: To evaluate the Ki-67 proliferation index and its correlation with different histological grades of Oral squamous cell carcinoma.
Methods: This retrospective immunohistochemical study was conducted at the Pathology Department of Mayo Hospital, Lahore, from January 2024 to May 2025. A total of 30 histopathologically confirmed cases of OSCC were selected. Hematoxylin and eosin (H&E) stained slides were used for grading tumors, followed by immunohistochemical staining for Ki-67. The staining intensity and percentage of positively stained tumor cells were evaluated and scored.
Results: Among the 30 cases, 6 (20%) showed no immunoreactivity for Ki‑67, 1 case (3%) exhibited mild staining, 13 cases (43.3%) demonstrated moderate staining, and 10 cases (33.3%) displayed intense Ki‑67 expression. A significant positive correlation was found between higher Ki-67 expression and poor tumor differentiation (p < 0.05). High-grade tumors (moderately and poorly differentiated OSCC) exhibited markedly increased Ki-67 labeling index as compared to well-differentiated tumors.
Conclusion: This study reinforces the utility of Ki-67 as a reliable proliferative marker in oral squamous cell carcinoma. Its expression correlates significantly with histological grade, indicating its potential role in prognostication and guiding therapeutic strategies.
Keywords: Carcinoma Squamous Cell; Cell Proliferation; Immunohistochemistry; Ki-67 Antigen; Mouth Neoplasms; Neoplasm Grading; Tumor Cells Malignant.
References
Zhang SZ, Xie L, Shang ZJ. Burden of oral cancer on the 10 most populous countries from 1990 to 2019: estimates from the global burden of disease study 2019. Int J Environ Res Public Health. 2022;19(2):875. https://doi.org/10.3390/ijerph19020875
Filho AM, Warnakulasuriya S. Epidemiology of oral cancer in South and South‐East Asia: Incidence and mortality. Oral Dis. 2024;30(8):4847-4854. https://doi.org/10.1111/odi.14906
Younas S, Riaz N, Ehsan-ul-Haq M, Hanif S. Epidemiological and Clinico-pathological spectrum of oral squamous cell carcinoma in patients presenting to a major tertiary care hospital in Lahore, Pakistan. Professional Med J. 2023;30(01):75-81.
https://doi.org/10.29309/TPMJ/2023.30.01.7234
Govindaraj PK, Kallarakkal TG, Mohd Zain R, Tilakaratne WM, Lew HL. Expression of Ki-67, Cornulin and ISG15 in non-involved mucosal surgical margins as predictive markers for relapse in oral squamous cell carcinoma (OSCC). PLoS One. 2021;16(12):e0261575.
https://doi.org/10.1371/journal.pone.0261575
Nazar M, Naz I, Mahmood MK, Hashmi SN. Immunohistochemical expression of Cyclin D1 and Ki-67 in primary and metastatic oral squamous cell carcinoma. Asian Pac J Cancer Prev: APJCP. 2020;21(1):37-41. https://doi.org/10.31557/APJCP.2020.21.1.37
Ahmad B, Asif M, Jamal S, Khan MZ, Khadim MT. Expression of Ki-67 and Βeta-Catenin in pseudoepitheliomatous hyperplasia and squamous cell carcinoma in oral mucosal biopsies: an immunohistochemical study. Asian Pac J Cancer Prev: APJCP. 2020;21(1):157-161. https://doi.org/10.31557/APJCP.2020.21.1.157
Zdrojewski J, Nowak M, Nijakowski K, Jankowski J, Scribante A, Gallo S, et al. Potential immunohistochemical biomarkers for grading oral dysplasia: a literature review. Biomedicines. 2024;12(3):577. https://doi.org/10.3390/biomedicines12030577
Wang Y, Dai M, Chen X. Prognostic and clinicopathological value of Ki-67 in patients with oesophageal squamous cell carcinoma: a systematic review and meta-analysis. BMJ Open. 2024;14(6):e083637. https://doi.org/10.1136/bmjopen-2023-083637
Nielsen TO, Leung SC, Rimm DL, Dodson A, Acs B, Badve S, et al. Assessment of Ki67 in breast cancer: updated recommendations from the international Ki67 in breast cancer working group. JNCI: J Natl Cancer Inst. 2021;113(7):808-819.
https://doi.org/10.1093/jnci/djaa201
Gadbail AR, Sarode SC, Chaudhary MS, Gondivkar SM, Tekade SA, Yuwanati M, et al. Ki67 Labelling Index predicts clinical outcome and survival in oral squamous cell carcinoma. J Appl Oral Sci. 2021;29:e20200751. https://doi.org/10.1590/1678-7757-2020-0751
Civico-Ortega JL, Gonzalez-Ruiz I, Ramos-Garcia P, Cruz-Granados D, Samayoa-Descamps V, González-Moles MÁ. Prognostic and clinicopathological significance of epidermal growth factor receptor (EGFR) expression in oral squamous cell carcinoma: systematic review and meta-analysis. Int J Mol Sci. 2023;24(15):11888.
https://doi.org/10.3390/ijms241511888
Deepa DC, Balakrishnan S. Correlation between Ki-67 labeling index and mitotic index in Head and neck squamous cell carcinoma. Indian J Pathol Microbiol. 2024;67(4):835-840.
https://doi.org/10.4103/ijpm.ijpm_447_23
Takkem A, Barakat C, Zakaraia S, Zaid K, Najmeh J, Ayoub M, et al. Ki-67 prognostic value in different histological grades of oral epithelial dysplasia and oral squamous cell carcinoma. Asian Pac J Cancer Prev: APJCP. 2018;19(11):3279-3286.
https://doi.org/10.31557/APJCP.2018.19.11.3279
Chen W, Lin G, Chen Y, Cheng F, Li X, Ding J, et al. Prediction of the Ki-67 expression level in head and neck squamous cell carcinoma with machine learning-based multiparametric MRI radiomics: a multicenter study. BMC Cancer. 2024;24(1):418.
https://doi.org/10.1186/s12885-024-12026-x
Apoorva CC, Ananthaneni A, Kumar AJ, Guduru VS, Puneeth HK. Evaluation of USP22 and Ki-67 expression in oral squamous cell carcinoma: An immunohistochemical study. J Oral Maxillofac Pathol. 2023;27(4):679-684. https://doi.org/10.4103/jomfp.jomfp_262_23
Kumar Sr S, Pandey J, Bharti S, Senapati S. Analysis of the Ki-67 proliferation index in relation to tumor, node, and metastasis (TNM) stage in patients with oral cavity squamous cell carcinoma. Cureus. 2024;16(7):e63751. https://doi.org/10.7759/cureus.63751
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Copyright (c) 2025 Aliya Muzafar, Ifrah Ahmed, Hamna Ahmad, Samreen Hameed, Rabia Altaf, Numrah Bilal Butt