{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:00:57Z","timestamp":1760058057012,"version":"build-2065373602"},"reference-count":81,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: To evaluate the prognostic impact of immunohistochemical ki-67 staining analysis regarding lymph node involvement and survival data (overall\/progression-free survival) in squamous cell carcinoma of the vulva. Methods: A systematic literature search of English and German articles was conducted (PubMed, Embase, Scopus, Web of Science) from 1980 to December 2023, including the search terms \u201cvulvar Neoplasms\u201d, \u201cvulvar cancer\u201d, \u201cvulvar carcinoma\u201d, \u201cvulvar tumor\u201d, \u201dvulvar tumour\u201d, \u201cvulvar malignancy\u201d, \u201cvulvar malignant\u201d, \u201cki-67\u201d, \u201cMIB-1\u201d, \u201cMIB1\u201d, \u201cproliferative index\u201d, \u201cproliferative activity\u201d, \u201cmitotic index\u201d, and \u201cmitotic count\u201d. Study quality was assessed using a two-step \u201cmixed-criteria\u201d approach; to synthesize study results, a narrative summary is provided. Results: In total, 13 studies were included in this systematic literature review. In general, two distinct methods of staining interpretation could be retrieved: A \u201cpattern-based\u201d method, as well as a cell count-based method. Ten of the included studies examined the relationship between ki-67 and lymph node involvement, nine studies included survival data as a parameter of interest; and only five studies defined both groin lymph node metastasis and survival data as outcome variables. While nine out of ten studies found no statistically significant association between ki-67 staining and lymph node metastasis, five out of nine studies determined an association between ki-67 status and overall survival, especially when employing a \u201cpattern-based\u201d method of staining interpretation. Conclusions: The prognostic value of ki-67 staining in terms of survival data has been reported ambivalently and should be subject to future studies. Furthermore, we did not find convincing evidence of an association between ki-67 and lymph node involvement.<\/jats:p>","DOI":"10.3390\/jcm14062045","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T15:24:56Z","timestamp":1742225096000},"page":"2045","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ki-67 as a Prognostic Marker in Squamous Cell Carcinomas of the Vulva: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Gilbert Georg","family":"Klamminger","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elke","family":"Eltze","sequence":"additional","affiliation":[{"name":"Department of General and Special Pathology, Saarland University (USAAR), Saarland University Medical Center (UKS), 66421 Homburg, Germany"},{"name":"Institute of Pathology, Saarbr\u00fccken-Rastpfuhl, 66113 Saarbr\u00fccken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1055-7249","authenticated-orcid":false,"given":"Annick","family":"Bitterlich","sequence":"additional","affiliation":[{"name":"Department of General and Special Pathology, Saarland University (USAAR), Saarland University Medical Center (UKS), 66421 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-9490","authenticated-orcid":false,"given":"Yaman","family":"Degirmenci","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1547-4968","authenticated-orcid":false,"given":"Annette","family":"Hasenburg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of General and Special Pathology, Saarland University (USAAR), Saarland University Medical Center (UKS), 66421 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3865-6833","authenticated-orcid":false,"given":"Meletios P.","family":"Nigdelis","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Saarland University Medical Center (UKS), 66421 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/ijc.2910310104","article-title":"Production of a Mouse Monoclonal Antibody Reactive with a Human Nuclear Antigen Associated with Cell Proliferation","volume":"31","author":"Gerdes","year":"1983","journal-title":"Int. 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