Nuclear grading of endometrial cancer harbors heterogenous prognostic groups as detected by proliferation activity

Objective: Nuclear grading, in addition to the histopathological result of every tumor, is responsible for consecutive treatment designs. Ki-S5 is the monoclonal antibody against a formalin-resistant epitope of the Ki-67 antigen and can be determined in paraffin-embedded samples. The aim of the study was a comparative analysis of the nuclear grading of endometrial cancer and the proliferation marker Ki-SS. Methods: In 126 specimens of endometrial cancer the proliferation activity of the monoclonal antibody Ki-SS was determined (strepravidin-biotin-complex method) in correlation to nuclear grading. In the group of grade 2, stages Ib and Ic andenocarcinomas, proliferation rates were compared. to recurrence rates. Results: Divergent proliferation rates resulted. Adenoacanthomas showed a relatively low proliferation rate (<28%). For the: andenosquamous carcinomas the ploliferation rate ranged between 28-43%. The largest group of adenocarcinomas showed proliferation rates from 5-74%. A clear dependency between increasing proliferation rates and decreasing differentiation (nuclear grading 2-3) was observed. In the small group of patients with andenocarcinomas. nuclear grading G2. stages Ib and Ic, 38 suffered no recurrence after 6-10 years. However, the six patients with proliferation rates of over 35% all suffered a recurrence. Conclusions: The results emphasize the need to differentiate G2 tumors, depending on their proliferation rate, into low risk (KiS5<35%) and high risk cases (Ki-S5>35%).