• Maria Aslam Army Medical College Rawalpindi (National University of Medical Sciences) Pakistan
  • Muhammad Tahir Khadim National Public Health Lab Specialist, Chemonics (USAID, GHSC-PSM) Pakistan
  • Syed Naeem Raza Hamdani Combined Military Hospital Multan (National Institute of Medical Sciences) Pakistan
  • Farah Ahsan Armed Forces Institute of Pathology (National University of Medical Sciences) Rawalpindi Pakistan
  • Syed Salman Ali Combined Military Hospital Abbottabad Pakistan


Objective: Bladder carcinoma is a prevalent urinary malignancy causing morbidity and mortality worldwide. The main aim of this study was to determine the frequency of immunohistochemical expression of Ki67 in urothelial carcinoma on TURBT bladder biopsies at our centre.

Material and Methods: A descriptive cross-sectional study was conducted in the department of Histopathology, Combined Military Hospital Multan from 13 June 2017 to 12 December 2017 on 79 bladder biopsies from the patients of urothelial carcinoma. Age, gender, grade of the tumor and results of immunomarker Ki67 were recorded. Computer software program SPSS version 21 was used for data analysis. Mean and SD calculation was done for numerical variables like age. Effect modifiers like age, gender and tumor grade were controlled through stratification. Post stratification Chi square test was applied. Percentages and frequency calculations were performed for gender, age, immunohistochemical expression of Ki67 as well as tumor grade. p-value <0.05 was considered as statistically significant.

Results: Out of 79 patients of urothelial carcinoma, 47 (59.49 %) were males and 32 (40.51 %) were females with a male to female ratio of 1.5:1. Patients age varied between 40 and 90 years with an average age of 66.7 years and SD of ±12.49. Among 79 biopsies, 51 (64.56%) were low grade tumors and 28 cases (35.44%) were high grade tumors. Out of 79 cases,23 cases (29.11%) were muscle invasive and 56 cases (70.81%) were noninvasive. 59 (74.68%) urothelial carcinoma cases were Ki67 positive whereas 20 cases (25.32%) did not exhibit Ki67 positivity. No signiï¬cant statistical association was observed among age, tumour grade, gender and Ki67 IHC results.

Conclusion: The high immunoexpression of Ki67 in urothelial carcinoma bladder is associated with a poor prognosis. Ki67 ASOs (Antisense deoxyoligonucleotides) markedly inhibit tumor growth and can be a promising target for molecular therapies. Ki67 immunoexpression can identify the subpopulation of patients which are more likely to respond to a given therapy. The precision of prognosis can be improved which can be useful in pinpointing the patients with greater risk of disease progression, thereby furnishing a valuable indicator for the clinical management of these patients, which might get advantage from adjuvant treatments.

Key Words: Ki67, Urothelial carcinoma, Immunohistochemical expression.