Identification of proliferating cells in human gliomas using the monoclonal antibody Ki-67

Ki-67 is a monoclonal antibody directed against a nuclear antigen present only in proliferating cells in the G1, S, G2, and M phases of the cell cycle. Fifty-one frozen glioma specimens were stained with Ki-67 using the avidin-biotin immunoperoxidase system. For each tumor, six different randomly selected fields were examined. The percentage of Ki-67-positive cells in the total number of cells in the five fields counted with counterstaining has been calculated. The areas of necrosis and the vascular endothelial cells when they were distinguishable were not included in the calculation. The indices determined on this material ranged from 0% to 4.5% (mean, 1.0; SD, 1.5) for 16 low grade astrocytomas; from 0.7% to 7.4% (mean, 3.5; SD, 2.2) for 8 anaplastic astrocytomas; and from 1.7% to 32.2% (mean, 11.1; SD, 8.2) for 27 glioblastomas. The differences among the means of each group are statistically significant. Five patients with malignant gliomas with an index of less than 2.5 had survival times of more than 40 weeks. These results show that the Ki-67 index of proliferating cells in human gliomas correlates with the usual histological classification of these tumors. There is a potential interest in using this technique in routine histopathology because it is simple and more rapid than the classic methods of evaluation of proliferating cells.