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Matthew Sniegowski, Bita Esmaeli; Ki67 Proliferation Index as a Prognostic Factor in Ocular Adnexal Lymphoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5350.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular adnexal lymphoma (OAL) is the most common primary orbital malignancy in adults. The purpose of our study was to evaluate the prognostic significance of the Ki67 proliferation index in OAL.
The medical records of all patients with a diagnosis of orbital and ocular adnexal lymphoma treated by the senior author (B.E.) between November 1st 1998 and November 1st 2012 at a single tertiary cancer center were reviewed. All consecutive patients that had a Ki67 proliferation index included in their pathology report were included in this study. Patients were grouped into low (≤35% Ki67 proliferation index) and high (>35% Ki 67 index) groups based on Ki67. Primary endpoints were progression free survival (PFS), systemic disease at diagnosis and lymphoma-related death.
Overall, 112 patients with OAL were identified, of these patients 52 patients had a Ki67 proliferation index included in their pathology report and were included the study. Thirty-two patients had primary OAL (61.5%) and twenty had secondary OAL (38.5%). For primary OAL we found no difference between PFS and Ki67 index both within a given histological subtype and between groups. The PFS was 76.9% for patient with a low Ki67 index and MALT lymphoma and 77.8% for patients with a high Ki67 index and DLBCL. Furthermore, within the subgroups of MALT and follicular lymphoma we found no correlation between an elevated Ki67 proliferation index and systemic disease at the time of diagnosis. For instance, 38.5% of patients with a low Ki67 index MALT lymphoma had systemic disease at the time of diagnosis while no patient with MALT lymphoma and an elevated Ki67 index had systemic disease at the time of diagnosis. However, in patients with secondary OAL, we found a decreased PFS with increased Ki67 proliferation index.
An elevated Ki67 proliferation index was correlated with worse outcomes in secondary OAL, however, we were unable to find a similar correlation with primary OAL.
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