Prognostic significance of ki-67 proliferation index in supratentorial fibrillary astrocytic neoplasms

Thomas J. Montine, Jacob J. Vandersteenhoven, Alasandra Aguzzi, Orst B. Boyko, Richard K. Dodge, Billie Jo Kerns, Peter C. Burger

Research output: Contribution to journalArticlepeer-review

118 Scopus citations


HISTOLOGICAL GRADING OF fibrillary astrocytic neoplasms has proved to be a valuable prognostic tool, but potentially could benefit from more objective data, such as estimates of proliferative rate. The authors have investigated the prognostic utility of quantitative Ki-67 immunoreactivity in a prospective survival analysis of 36 adult patients with astrocytoma, anaplastic astrocytoma, or glioblastoma multiforme diagnosed between 1987 and 1992. A digital image analyzer was used to assay proliferation indices (PIs) in surgical biopsy specimens obtained at first diagnosis (32 of 36) or at a second biopsy of histologically unchanged high-grade disease (4 of 36). A Ki-67 PI of ≥7.5% was associated with higher histological grade and poorer survival, and the Ki-67 PI was more significantly related to survival (P < 0.001) than histological grade as determined by a modified Ringertz grading system (P = 0.002). Survival analysis within histological grades suggested that astrocytoma patients with PI ≥ 3% may be at increased risk for shorter survival than those with PI < 3%.

Original languageEnglish (US)
Pages (from-to)674-679
Number of pages6
Issue number4
StatePublished - Apr 1994
Externally publishedYes


  • Astrocytoma
  • Prognosis
  • Proliferation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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