[The morphological parameters of cell regeneration in gastric carcinomas and their prognostic value]

To make an integrated assessment of the proliferative activity of gastric cancer (GC) (Ki-67 and mitotic index - MI) and the degree of tumor cell apoptosis (apoptotic index - AI), by calculating the cell regeneration coefficient (CRC) in relation to the histological variant and functional immunophenotype (IPT) of a tumor and to determine if there is a possible association of the above indicators with adjusted 4-year relapse-free survival rates.

Surgical specimens obtained from 55 patients with CC were examined. The tumors were divided into histological variants in accordance with the International histological classification criteria (WHO, 2010) and into IPT by a set of the produced mucins MUC1, MUC2, MUC5AC, MUC6, and the glycoprotein CD10. MI and AI were estimated from the number of mitoses and apoptotic bodies in the 5-microm-thick hematoxylin- and eosin-stained tumor histological sections; Ki-67 was determined by scoring the number of its immunopositive nuclei per 1000 counted tumor cells at x1000 magnification.

The values of Ki-67, MI, AI, and CRC in GC were found to be significantly related to the tumor histological variant and IPT; and MI, AI and CRC were also associated with adjusted 4-year relapse-free survival rates. The Ki-67 index in the gastric carcinomas is of no prognostic value, which is most likely to be attributable to the inadequacy of this indicator for the estimation of the biological potential of tumors growing in the tissues with constantly regenerative cell populations, which is peculiar to the epithelium of the gastric mucosa, particularly to that of the necks of the glands, which most GCs are histogenetically related to.

Thus, the values of MI, AI, and CRC are best used as additional prognostic factors in patients with GC. At the same time, the prognostic value of Ki-67 in GC has been overestimated, as shown by the authors' data.