Predictive value of the fraction of cancer cells immunolabeled for proliferating cell nuclear antigen or Ki67 in biopsies of head and neck carcinomas to identify lymph node metastasis: comparison with clinical and radiologic examinations.

Background: Neck metastasis is a major prognostic factor of head and neck carcinoma, but its preoperative detection is currently unreliable. Molecular markers of the metastatic potential of a carcinoma would help to avoid unnecessary neck dissection in patients with nonmetastatic cancer.

Methods: The fractions of cancer cells immunostained for proliferating cell nuclear antigen (PCNA) and Ki67 were determined in 80 preoperative biopsy specimens of head and neck carcinomas. The value of both indexes to detect metastasis in the subsequent neck dissection was compared with that of the clinical and radiologic examinations.

Results: PCNA and Ki67 indexes correlated with neck metastasis. Cutoff points were determined for both indexes to discriminate metastatic from nonmetastatic carcinomas. By multivariate logistic regression, these indexes were significant predictors of metastases, together with clinical T stage and neck palpation.

Conclusion: The fraction of cancer cells immunolabeled for PCNA or Ki67 in preoperative biopsy specimens is helpful to predict neck metastasis.