The Importance of Immunohistochemical Evaluation of Ki67 in Detecting Early Malignant Changes in Colorectal Adenomatous Polyps

Abstract

Objective: To assess the prevalent clinicopathogical parameters of Adenomatous polyps and association of ki67 with them in order to elucidate its significance as potent marker in determining early malignant changes

Study Design: Retrospective study

Place and Duration of Study: This study was conducted at the Histopathology department and Molecular diagnostic Research laboratory (MDRL), Dr. Ziauddin University and Hospital, Karachi from November 2021 to November 2023.

Methods: A total of 55 colorectal adenomatous polyps and clinical data was retrieved. Fresh frozen plasma sections were stained under Hematoxylin and eosin stain and further analyzed with KI67 IIHC stain. A P-value of less than 0.05 was deemed statistically significant.

Results: Among all 55 cases, 12 (21.8%) cases had age <50 years and 43 (78.2%) cases had age >50 years. Males predilection was observed. Most common clinical symptom was bleeding per rectum in 35 (63.64%) cases, followed by weight loss and chronic diarrhea, anemia, chronic abdominal pain, constipation while one case was accidentally reported on routine endoscopy (1.81%). 41 polyps (74.54%) were <20mm and 14 polyps (25.45%) were >20mm. Most common site was rectum (41.8%), followed by ascending and sigmoid colon, descending colon and transverse colon. Strong association was observed between size of colorectal polyps and grade of dysplasia with ki67 score.

Conclusion: When identifying the individuals with colorectal adenomatous polyps who require close surveillance in follow-up, size of polyp, high grade dysplasia and significant positive immunohistochemistry markers of Ki-67 may be useful criteria. This shall set a target population for screening of pre malignant changes.