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Typing and Grading of Soft Tissue Tumors and their Correlation with Proliferative Marker Ki-67

Abstract

Sumiti Gupta, Samta Shakya, Meenu Gill, Sonia Hasija, Nisha Marwah, Rajnish Kalra and Rajeev Sen

Aim and Objective: The main aim of this study is to categorize, type, grade of soft tissue tumors & correlate it with Ki-67 proliferative index.
Material and Methods: The present study was conducted in the Department of Pathology, PGIMS, Rohtak. The study group comprised of excised 44 cases of STT (soft tissue tumors) specimens. Tumor grade was assigned based on the FNCLCC (Fédération Nationale des Centers de Lutte Contre le Cancer) grading system. According to the Ki-67 index the patients were divided into two groups: high index group (>50/10HPF) and low index group (<50/10HPF). These grades were correlated with proliferative activity using Ki-67 index.
Results: Out of 44 soft tissue tumors in our study 12 (27.27%) were diagnosed as benign and 32 (72.72%) were diagnosed as malignant soft tissue tumors. Average size of benign tumors was 4.50 cm and that of malignant tumors was 10.33 cm. Maximum number of soft tissue tumor were located in the extremities i.e.10 (22.72%) in upper extremity and 24 (54.54%) in the lower extremity. The commonest site affected was thigh (18.2%). Out of the 32 cases of (STS) soft tissue sarcomas, 15 (46.87%) were Grade 2, 13 (40.63%) were Grade 3 and 4 (12.5%) were Grade 1. MPNST (malignant peripheral nerve sheath tumor) had the largest number of cases with Grade 3 (31.3%). All the benign STT had low Ki-67 index, while the Ki-67 index was low in 12 STS and high in 20 STS. The size as well as grade of the tumors showed a significant correlation with Ki-67 index.
Conclusion: Grading based on assessment of morphologic variables is one of the most important factors for predicting the prognosis of the patients with STS. Therefore, it should be a part of the pathology report and should be adapted to the modern management of patients.

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