Rassi, S (2017) Histopathological study of soft tissue tumours and correlation of histologic grade of soft tissue sarcomas with proliferative marker KI 67 in selected cases. Masters thesis, Madurai Medical College, Madurai.
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Abstract
BACKGROUND: Soft tissue tumours have diagnostic and therapeutic challenge due to a wide variety of histomorphological patterns. Soft tissue sarcomas are relatively infrequent and constitute less than 1% of overall malignant neoplasms. This study aims to analyze the distribution of soft tissue tumours in relation to age, gender and site and their histopathological classification based on behaviour and specific lineage of differentiation. Immunohistochemical evaluation of Ki-67 is a rapid tool to assess the cellular proliferation better than mitotic index. This study aims to determine the correlation between the histologic grade and Ki-67 index and the role of Ki-67 as a significant prognostic factor in soft tissue sarcomas. METHODS: The study was carried out in the Department of Pathology, Madurai Medical College, Madurai, during the period from July 2014 to August 2016 on 100 specimens of soft tissue tumours received in the department after exclusion of lipomas. After adequate fixation, representative bits were taken, processed and stained with Haematoxylin and Eosin. The cases were classified based on WHO classification, 2013. Soft tissue sarcomas were graded by FNCLCC grading system. Selected cases of sarcomas were subjected to immunohistochemical evaluation with proliferative marker, Ki-67. Spearman’s Rho and Pearman’s correlation coefficients were calculated to determine the strength of correlation between the histologic grade and Ki-67 labelling index. The observations were compared with other studies and inferences drawn. RESULTS: Soft tissue tumours constituted only about 1.3% of all neoplasms during the study period. Benign tumours (50%) outnumbered intermediate (11%) and malignant soft tissue tumours (39%). Soft tissue tumours were more common in males (52%) than females (48%) and frequently observed in the sixth decade. The sites of predilection were upper extremities for benign tumours and lower extremities for malignant tumours. Most common benign soft tissue tumour was Neurofibroma (19%) followed by Schwannoma (14%). Undifferentiated pleomorphic sarcomas were the most common malignant soft tissue tumour (28%). In FNCLCC grading, most of the sarcomas were grade III (42%) followed by grade II (37%) and grade I (21%). 50% of grade III sarcomas were undifferentiated pleomorphic sarcomas. Ki-67 index was low in grade I sarcoma, variable in grade II sarcomas and high in grade III sarcomas. Spearman’s rho and Pearman’s correlation R values were 0.77 and 0.75 respectively which showed a strong correlation between the histologic grade and Ki-67 index. CONCLUSION: There is positive correlation between the histologic grade and Ki-67 proliferative index in soft tissue sarcomas. Ki-67 index can be used as an independent prognostic factor to predict the risk of distant metastasis. Hence prospective evaluation of Ki-67 should be carried out in patients with primary soft tissue sarcomas for planning further adjuvant treatment modalities.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201413102 |
| Uncontrolled Keywords: | Soft tissue Sarcomas, FNCLCC (Federation Nationale des Centres de Lutte Contre le Cancer) grading, Immunohistochemistry, Ki-67. |
| Subjects: | MEDICAL > Pathology |
| Depositing User: | Subramani R |
| Date Deposited: | 18 Jul 2020 16:39 |
| Last Modified: | 18 Jul 2020 16:39 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12533 |
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