Low expression of Ki-67/MIB-1 labeling index in IDH wild type glioblastoma predicts prolonged survival independently by MGMT methylation status

J Neurooncol. 2023 Jun;163(2):339-344. doi: 10.1007/s11060-023-04342-2. Epub 2023 May 25.

Abstract

Purpose: The Ki-67/MIB-1 labeling index (LI) is clinically used to differentiate between high and low-grade gliomas, while its prognostic value remains questionable. Glioblastoma (GBM) expressing wild-type isocitrate dehydrogenase IDHwt, a relatively common malignant brain tumor in adults, is characterized by a dismal prognosis. Herein, we have retrospectively investigated the prognostic role of Ki-67/MIB-1-LI in a large group of IDHwt GBM.

Methods: One hundred nineteen IDHwt GBM patients treated with surgery followed by Stupp's protocol in our Institution between January 2016 and December 2021 were selected. A cut-off value for Ki-67/MIB-1-LI was used with minimal p-value based approach.

Results: A multivariate analysis showed that Ki-67/MIB-1-LI expression < 15% significantly correlated with a longer overall survival (OS), independently from the age of the patients, Karnofsky performance status scale, extent of surgery and O6-methylguanine (O6-MeG)-DNA methyltransferase promoter methylation status.

Conclusions: Among other studies focused on Ki-67/MIB-1-LI, this is the first observational study showing a positive correlation between OS of IDHwt GBM patients and Ki-67/MIB-1-LI that we propose as a new predictive marker in this subtype of GBM.

Keywords: Glioblastoma; IDH wild-type; Ki-67; MIB-1.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Brain Neoplasms* / pathology
  • DNA Methylation
  • DNA Modification Methylases / genetics
  • DNA Modification Methylases / metabolism
  • DNA Repair Enzymes / genetics
  • DNA Repair Enzymes / metabolism
  • Glioblastoma*
  • Glioma* / pathology
  • Humans
  • Isocitrate Dehydrogenase / genetics
  • Isocitrate Dehydrogenase / metabolism
  • Ki-67 Antigen / metabolism
  • Methylation
  • O(6)-Methylguanine-DNA Methyltransferase / genetics
  • Prognosis
  • Retrospective Studies
  • Tumor Suppressor Proteins / genetics
  • Tumor Suppressor Proteins / metabolism

Substances

  • Ki-67 Antigen
  • O(6)-Methylguanine-DNA Methyltransferase
  • Isocitrate Dehydrogenase
  • DNA Modification Methylases
  • DNA Repair Enzymes
  • MGMT protein, human
  • Tumor Suppressor Proteins