{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:41:29Z","timestamp":1760013689352},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2010,6,17]],"date-time":"2010-06-17T00:00:00Z","timestamp":1276732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Morphometry [nuclear Ki\u201067 labelling, mitotic activity index (MI), and volume\u2010corrected mitotic index (M\/V)] for periampullary cancers using tissue microarrays has not been performed previously. The purpose of the study was to assess these indices on tissue microarray (TMA) sections constructed from patients with periampullary cancers and study their association with clinicopathological variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Immunohistochemical staining for Ki\u201067 was performed on formalin\u2010fixed pancreatic TMA sections. Expression of Ki\u201067 was assessed as the percentage of cancer cell nuclei expressing MIB1, MI as the mean percentage of Ki\u201067 from 10 random high\u2010power fields, and M\/V was calculated after standardizing MI for connective tissue volume and microscope parameters in the tumor using established protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients \u226570 years with periampullary cancers had higher Ki\u201067 expression (&gt;15) compared with patients &lt;70 years of age (\u03c7<jats:sup>2<\/jats:sup> = 3.9, <jats:italic>P<\/jats:italic> = 0.047). Ki\u201067 expression was higher in tumors \u22652\u00a0cm (\u03c7<jats:sup>2<\/jats:sup> = 4.9, <jats:italic>P<\/jats:italic> = 0.028) compared with smaller tumors. Higher MI (&gt;15) was clearly associated with worsening histological grade (\u03c7<jats:sup>2<\/jats:sup> = 9.2, <jats:italic>P<\/jats:italic> = 0.010). The median survival for tumors of the pancreaticobiliary subtype (pancreatic ductal adenocarcinoma and cholangiocarcinoma) was 43\u00a0months in the group with an M\/V score of &lt;20, compared with 18\u00a0months for the group with a score \u226520 (<jats:italic>P<\/jats:italic> = 0.001). There was no statistically significant difference in survival, based on M\/V score, for tumors of the intestinal subtype (ampullary and duodenal adenocarcinoma).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In periampullary cancers, Ki\u201067 and MI are proliferative indices predictive of tumor behavior. M\/V was predictive of survival in tumors of the pancreaticobiliary subtype.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0681-3","type":"journal-article","created":{"date-parts":[[2010,6,16]],"date-time":"2010-06-16T21:11:40Z","timestamp":1276722700000},"page":"2115-2121","source":"Crossref","is-referenced-by-count":9,"title":["Predictive Value of Tumor Proliferative Indices in Periampullary Cancers: Ki\u201067, Mitotic Activity Index (MI) and Volume Corrected Mitotic Index (M\/V) Using Tissue Microarrays"],"prefix":"10.1002","volume":"34","author":[{"given":"Mark M.","family":"Aloysius","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit Nottingham University Hospitals, Queen\u2019s Medical Centre NG7 2UH Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivanthi J.","family":"De Silva 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