Comparison of SKIP expression in malignant pleural mesotheliomas with Ki-67 proliferation index and prognostic parameters

Our plain-English summary of Comparison of SKIP expression in malignant pleural mesotheliomas with Ki-67 proliferation index and prognostic parameters, by G. Türkcü, U. AlabalIk, A.N. Keles, et al (Polish Journal of Pathology, 2016).

The study

• Authors: G. Türkcü, U. AlabalIk, A.N. Keles, I. Ibiloglu, M. Küçüköner, H.S. Sen, H. Büyükbayram
• Journal: Polish Journal of Pathology
• Published: 2016;67(2):108-13
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We aimed to determine the presence of SKI-interacting protein (SKIP) expression in malignant pleural mesothelioma (MPM) and its effect on prognosis by investigating SKIP correlation with the Ki-67 proliferation index and prognostic parameters. Pathological preparations of the patients diagnosed with MPM between 2006 and 2012 were evaluated. Immunohistochemical analyses were performed to evaluate the expression of SKIP and the Ki-67 proliferation index. Correlations between SKIP expression, clinicopathological factors and survival were investigated. Survival data were calculated using the Kaplan-Meier method, and Cox regression analysis was used to evaluate the prognostic value of the variables. In total, 52 patients were evaluated in the study; 36 of them were male and 16 were female. The mean age of the patients was 62.3 ±12.2 years. The median overall survival period was 8.5 months. Factors negatively affecting general survival in the univariate analysis included high SKIP expression, Ki-67 proliferative index over 30%, presence of non-epithelioid type MPM and stage III-IV disease (p < 0.05). Cox regression analysis revealed that high SKIP expression, high Ki-67 proliferative index and presence of non-epithelioid type MPM are independent factors that affect the survival rate. Higher SKIP expression is associated with poor prognosis in MPM.

In plain English

This retrospective study from Turkey examined stored tumor tissue from 52 patients diagnosed with malignant pleural mesothelioma between 2006 and 2012. They were the eligible patients out of 89 whose records were reviewed. The authors stained the tissue for SKIP, a protein involved in cell growth signaling, and Ki-67, a marker of dividing cells. The article did not report the patients' asbestos exposure. Both proteins were found in all tumors. 21 tumors had high SKIP levels, and 18 had a Ki-67 index above 30%. Median survival was 8.5 months. In the analysis combining all factors, three were each linked to shorter survival, with hazard ratios (and 95% confidence intervals) of 2.46 (1.23-4.93) for high SKIP, 4.56 (2.25-9.25) for Ki-67 above 30% and 2.39 (1.48-4.45) for non-epithelioid tumor type. Disease stage was not. Age and sex showed no statistically significant link to survival. SKIP and Ki-67 levels were moderately correlated. The authors concluded that SKIP was a useful predictor of poor prognosis. They called the study preliminary and small, needing a larger study to confirm it. Several of the article's numbers are inconsistent.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective study of archived tumor tissue and medical records, using immunohistochemical staining and survival analysis (Kaplan-Meier and Cox regression)
• Who was studied: 52 patients with malignant pleural mesothelioma diagnosed between 2006 and 2012 at Dicle University, Diyarbakir, Turkey, out of 89 whose records were reviewed. 36 were male and 16 female, with a mean age of 62.3 ±12.2 years. Tumor types: 45 epithelioid, 4 sarcomatoid, 3 biphasic.
• Exposure: No asbestos or other exposure data were reported for the patients. The factors studied were SKIP protein expression and the Ki-67 proliferation index in tumor tissue, measured by immunohistochemistry.
• Main results:
  • SKIP and Ki-67 were expressed in all tumor tissues. SKIP expression was high in 21 cases and low in 31 cases.
  • The Ki-67 proliferation index was greater than 30% in 18 cases and 30% or lower in 34 cases.
  • Median overall survival of all 52 patients was 8.5 months. The printed 95% confidence interval was 9.37-15.13.
  • In the univariate analysis, shorter survival (p less than 0.05) was linked to high SKIP expression, Ki-67 index over 30%, non-epithelioid tumor type and stage III-IV disease.
  • In the multivariate Cox regression, the hazard ratios were: SKIP 2.46 (95% CI 1.23-4.93, p less than 0.001); Ki-67 4.56 (95% CI 2.25-9.25, p = 0.03); histological type 2.39 (95% CI 1.48-4.45, p = 0.041).
  • Advanced stage was not an independent factor for survival in the multivariate analysis.
  • The authors reported no effect of age or gender on prognosis. In the Cox regression table, neither was statistically significant (age p = 0.108, sex p = 0.306).
  • There was a moderate positive correlation between the Ki-67 proliferation index and SKIP expression (r = 0.352, p = 0.011).
• The authors' conclusion: The authors concluded that SKIP expression correlated with the Ki-67 index and was a useful predictor of poor prognosis in malignant pleural mesothelioma. They also stated that clinical studies are needed to confirm this.
• Limitations the authors state:
  • The authors described the study as a preliminary investigation with a small sample size and said a larger study is needed to confirm the results.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Ki-67, Prognosis, Median Overall Survival, Non-epithelioid.

Related studies

• Loss of BAP1 Expression in Atypical Mesothelial Proliferations Helps to Predict Malignant Mesothelioma — R. Pillappa, J.J. Maleszewski, et al. (2018)
• Differential diagnosis of reactive mesothelial cells and malignant mesothelioma cells using the cell proliferation markers minichromosome maintenance protein 7, geminin, topoisomerase II alpha and Ki-67 — F. Kimura, I. Okayasu, et al. (2013)
• BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations — M. Cigognetti, S. Lonardi, et al. (2015)
• Is survivin expression prognostic or predictive in malignant pleural mesothelioma? — J. Hmeljak, N. Erčulj, et al. (2013)
• A new prognostic index for overall survival in malignant pleural mesothelioma: the rPHS (regimen, PS, histology or stage) index — Y. Kataoka, Y. Yamamoto, et al. (2015)
• Malignant peritoneal mesothelioma: prognostic significance of clinical and pathologic parameters and validation of a nuclear-grading system in a multi-institutional series of 225 cases — D.B. Chapel, J.J. Schulte, et al. (2021)

Browse return to medical research.