Research Article Open Access Journal of Surgery [Jurnalul de Chirurgie] J o u r n a l o f S u r g e r y [ J u r n a l u l d e C h i r u r g i e ] ISSN: 1584-9341 Volume 15 • Issue 1 • 6 J Surgery, an open access journal ISSN: 1584-9341 Keywords: Ki-67; Pancreatic ductal adenocarcinoma; Prognostic factors; Survival Introduction Pancreatic Ductal Adenocarcinoma (PDAC) is the most common malignant tumor of the pancreas (over 90%) [1,2] and one of the most aggressive neoplasms, with a survival of 2 years of 20% and 5 years of 5% [3]. Over 75% to 80% of patients with PDAC are diagnosed in advanced disease stages, either with distant metastasis or with the locally unresectable disease [4-6] and over 62% of patients with resectable tumors will develop liver metastasis afer curative surgery [7]. Te average survival in patients with surgical treatment is approximately 17-21 months, but this may be improved if patients follow adjuvant chemotherapy [8-12]. Tumor size, lymph nodal metastasis, perineural and microvascular invasion are considered as prognostic factors for pancreatic ductal adenocarcinoma [3,13]. Te Ki-67 antigen, cell cycle and cell proliferation marker is a nuclear antigen expressed in all cellular phases, except for the G0 phase [14]. Height Ki-67 index can be correlated with a recurrence rate of tumor and survival [15]. Materials and Method We reviewed retrospectively all patients admitted to a single university center between 1 January 2008 and 31 December 2016 and who were diagnosed with pancreatic cancer (ICD C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, and C25.9). Of these patients, only those with surgically resected pancreatic ductal adenocarcinoma were included in the study. For those patients who met the criteria for inclusion in the study, the observation sheets, postoperative evolution, tumor size, the final histopathological tumor staging, and survival rate were analyzed. The survival was calculated from the date of surgery to the patient’s death (the date of death was provided from the population record database). *Corresponding author: Irene Cianga-Spiridon, MD, First Surgical Unit, “St. Spiridon” Emergency University Hospital Iasi, Independentei Street, No 1, 700544, Iasi, Romania, Tel: +40(0)741024493; Fax: +40(0)232218272; E-mail: irenespiridon@yahoo.com Received April 09, 2019; Accepted April 28, 2019; Published May 05, 2019 Citation: Andriesi-Rusu F, Trofn A, Cianga-Spiridon I, Vlad N, Vasilescu A, et al. Ki 67 as Prognostic Factor in Surgically Resected Pancreatic Ductal Adenocarcinoma. Journal of Surgery [Jurnalul de chirurgie]. 2019; 15(1): 25-27 Copyright: © 2019 Andriesi-Rusu F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Pancreatic ductal adenocarcinoma is one of the most aggressive neoplasms, with a poor prognostic and overall survival, most of the patients (over 80%) being diagnosed in advanced stages of the disease, either with distant metastasis or with the locally unresectable tumor. The Ki-67 antigen is a nuclear antigen expressed in all cellular phases (except for the G0 phase) and a high Ki-67 index can be correlated with a recurrence rate of tumor and survival. Aim: The aim of our study was to demonstrate if the Ki-67 index can be used as a negative prognostic factor for survival. Methods: We reviewed retrospectively all patients with pancreatic ductal adenocarcinoma (confrmed histologically) and were selected only those with resectable tumors (19.5%). For these patients, immunoreactivity for Ki-67 was evaluated according to the percentage of positive tumor nuclei. The survival was calculated from the data of surgery to a patient’s death. Results: 19.5% of patients were diagnosed with surgically resectable tumors, with a mean tumor’s size of 3.3 cm. The overall survival rate at 2 years was 21.15%. The patients with a Ki-67 index over 80% had a signifcantly lower average survival than the other patients. Conclusions: The immunohistochemistry staining for Ki-67 can be applied as a prognostic marker for survival in resectable ductal pancreatic adenocarcinoma. Ki 67 as Prognostic Factor in Surgically Resected Pancreatic Ductal Adenocarcinoma Florina-Delia Andriesi-Rusu, Ana-Maria Trofn, Irene Cianga-Spiridon*, Nutu Vlad, Alin Vasilescu, Eugen Târcoveanu and Cristian Lupașcu First Surgical Unit, “St. Spiridon” Hospital, University of Medicine and Pharmacy “Gr.T. Popa” Iasi, Romania For every case, was selected one parafn block of primary tumor for the immunohistochemical detection of Ki-67. Immunoreactivity for Ki- 67 was evaluated according to the percentage of positive tumor nuclei. Te data obtained were processed using IBM SPSS Statistics for Windows, and the Mann-Whitney-U test, ANOVA, independent T-test were used to compare the means and the diferences between two independent groups on the same continuous, dependent variable, and the chi-square test, odds ratio, and Fisher exact test were used to determine the diference between two groups or if there is a relationship between two categorical variables, and Kaplan-Meier method with log- rank and Breslow tests of signifcance were used for overall survival. Te obtained results were considered statistically signifcant at a p<0.05. Result In our surgical unit, 349 patients were diagnosed with pancreatic carcinoma during 1 January 2008 and 31 December 2016. Of these, 281 patients (80.5%) were admitted in advanced disease (with metastasis at a distance or at a locally advanced stage) and benefted from biliodigestive anastomosis (n=171), pancreatic biopsies or metastasis biopsies (n=17)