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Abstract：
BACKGROUND: Ki-67 immunostaining is commonly used in neuroendocrine tumors to estimate the proliferative index and for grading. This study investigates its association with the invasiveness of follicular-derived thyroid carcinomas (TCs).
METHODS: A retrospective analysis of patients with TC at three McGill University teaching hospitals between January 2018 and November 2023 was conducted. The inclusion criteria included patients with malignant thyroid tumors and accessible Ki-67 LI data from final pathology specimens. The data collected included patient demographics, Ki-67 LI values, and different invasiveness attributes, such as molecular mutations, the histological subtype, lymphovascular invasion (LVI), extrathyroidal extension (ETE), and positive lymph nodes (LNs).
RESULTS: In total, 212 patients met the inclusion criteria, of which 80.7% were females and 19.3% were males. The Ki-67 LI ranged from 1% to 30%, with the majority of the cases within the range of 1-15%. A significant association was observed between higher Ki-67 LI and high-risk histological subtypes of thyroid carcinoma (p < 0.001). Similarly, Ki-67 LI was significantly associated with LVI and positive LN metastasis (p < 0.001 and p = 0.036, respectively). However, no significant association was found between the Ki-67 LI and gene mutations or ETE (p = 0.133 and p = 0.190, respectively). Using percentiles to establish a cutoff, patients with a Ki-67 LI higher than 6.7 showed a higher likelihood of being associated with invasive features.
CONCLUSIONS: Elevated Ki-67 LI can serve as an indicator of aggressiveness in follicular-derived TC, especially when associated with distinct histological subtypes, LVI and positive LNs.
METHODS: A retrospective analysis of patients with TC at three McGill University teaching hospitals between January 2018 and November 2023 was conducted. The inclusion criteria included patients with malignant thyroid tumors and accessible Ki-67 LI data from final pathology specimens. The data collected included patient demographics, Ki-67 LI values, and different invasiveness attributes, such as molecular mutations, the histological subtype, lymphovascular invasion (LVI), extrathyroidal extension (ETE), and positive lymph nodes (LNs).
RESULTS: In total, 212 patients met the inclusion criteria, of which 80.7% were females and 19.3% were males. The Ki-67 LI ranged from 1% to 30%, with the majority of the cases within the range of 1-15%. A significant association was observed between higher Ki-67 LI and high-risk histological subtypes of thyroid carcinoma (p < 0.001). Similarly, Ki-67 LI was significantly associated with LVI and positive LN metastasis (p < 0.001 and p = 0.036, respectively). However, no significant association was found between the Ki-67 LI and gene mutations or ETE (p = 0.133 and p = 0.190, respectively). Using percentiles to establish a cutoff, patients with a Ki-67 LI higher than 6.7 showed a higher likelihood of being associated with invasive features.
CONCLUSIONS: Elevated Ki-67 LI can serve as an indicator of aggressiveness in follicular-derived TC, especially when associated with distinct histological subtypes, LVI and positive LNs.
摘要：
背景：Ki-67免疫染色常用于神经内分泌肿瘤的增殖指数评估和分级。这项研究调查了其与滤泡源性甲状腺癌（TC）侵袭性的关系。
方法：对2018年1月至2023年11月在麦吉尔大学三家教学医院的TC患者进行回顾性分析。纳入标准包括甲状腺恶性肿瘤患者和最终病理标本中可获得的Ki-67LI数据。收集的数据包括病人的人口统计,Ki-67LI值，和不同的侵入属性，如分子突变，组织学亚型，淋巴管浸润（LVI），甲状腺外延伸（ETE），和阳性淋巴结（LN）。
结果：总计，212例患者符合纳入标准，其中女性占80.7%，男性占19.3%。Ki-67LI的范围从1%到30%，大多数病例在1-15%的范围内。在较高的Ki-67LI与甲状腺癌的高风险组织学亚型之间观察到显着关联（p<0.001）。同样，Ki-67LI与LVI和阳性LN转移显着相关（分别为p<0.001和p=0.036）。然而,Ki-67LI与基因突变或ETE之间未发现显著关联(分别为p=0.133和p=0.190).使用百分位数建立截止值，Ki-67LI高于6.7的患者显示与侵入性特征相关的可能性更高.
结论：Ki-67LI升高可以作为卵泡源性TC侵袭性的指标，特别是当与不同的组织学亚型相关时，LVI和正LN。
方法：对2018年1月至2023年11月在麦吉尔大学三家教学医院的TC患者进行回顾性分析。纳入标准包括甲状腺恶性肿瘤患者和最终病理标本中可获得的Ki-67LI数据。收集的数据包括病人的人口统计,Ki-67LI值，和不同的侵入属性，如分子突变，组织学亚型，淋巴管浸润（LVI），甲状腺外延伸（ETE），和阳性淋巴结（LN）。
结果：总计，212例患者符合纳入标准，其中女性占80.7%，男性占19.3%。Ki-67LI的范围从1%到30%，大多数病例在1-15%的范围内。在较高的Ki-67LI与甲状腺癌的高风险组织学亚型之间观察到显着关联（p<0.001）。同样，Ki-67LI与LVI和阳性LN转移显着相关（分别为p<0.001和p=0.036）。然而,Ki-67LI与基因突变或ETE之间未发现显著关联(分别为p=0.133和p=0.190).使用百分位数建立截止值，Ki-67LI高于6.7的患者显示与侵入性特征相关的可能性更高.
结论：Ki-67LI升高可以作为卵泡源性TC侵袭性的指标，特别是当与不同的组织学亚型相关时，LVI和正LN。
