Proliferative activity of colorectal adenocarcinoma: objectification of criteria of morphological evaluation

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


Aim of the study. To analyze the correlation between proliferative activities determined on the basis of routine histological staining and immunohistochemical reaction to the nuclear antigen Ki-67 in colorectal adenocarcinomas. Methods. Thirty adenocarcinomas of the colon and rectum were retrospectively evaluated. Evaluation of proliferative activity was performed on serial histological preparations stained with hematoxylin and eosin and treated with antibodies to Ki-67. Calculation was carried out in the “hot spots” under four microscope high power fields (≈1 mm2). Results. An estimate of the Kendall rank correlation coefficient demonstrated a high degree of direct relationship between the number of mitoses counted by routine staining and proliferative activity estimated by the immunohistochemical method (τ = 0.708, p < 0.05). All observations on the dispersion diagram could be divided into three “cloud” clusters with similar values for Ki-67 with practically the same number of mitoses. Conclusions. On the basis of routine histological examination, it is possible to separate colorectal carcinomas from tumors with a low (1-2/mm2), moderate (3-5/mm2), and high (≥6/mm2) mitotic activity corresponding to the proliferation index values of Ki-67 <30%, 30%-50%, and >50%, respectively.

Full Text

Restricted Access

About the authors

D P Kovtun

City Clinical Oncology Center; North-Western State Medical University named after I.I. Mechnikov

N M Anichkov

North-Western State Medical University named after I.I. Mechnikov

O G Polushin

City Clinical Oncology Center

E V Ponomaryeva

City Clinical Oncology Center

A I Lyubimov

S.M. Kirov Military Medical Academy

E Yu Kalinina

North-Western State Medical University named after I.I. Mechnikov


  1. Давыдов М.И., Аксель Е.М. Смертность населения России и стран СНГ от злокачественных новообразований в 2009 г. // Вестник РОНЦ им. Н.Н. Блохина РАМН. - 2011. - Т. 22. - № 3 (прил. 1). - С. 93-123. [Davydov MI, Aksel EM. Smertnost’ naseleniya Rossii i stran SNG ot zlokachestvennykh novo-obrazovaniy v 2009 g. Journal of N.N. Blokhin Russian Cancer Research Center RAMS. 2011;22(3S1):93-123. (In Russ.)]
  2. Ковальский Г.Б., Юрин А.Г. Опухоли кишечника // Пальцев М.А., Аничков Н.М. Атлас патологии опухолей человека. - М.: Медицина, 2005. - С. 213-231. [Kovalskiy GB, Yurin AG. Opukholi kishechnika. In: Paltsev MA, Anichkov NM. Atlas patologii opukholey cheloveka. Moscow: Meditsina; 2005. P. 213-231. (In Russ.)]
  3. Papapolychroniadis C. Environmental and other risk factors for colorectal carcinogenesis. Tech Coloproctol. 2004;8 Suppl 1:s7-9. doi: 10.1007/s10151-004-0097-x.
  4. Пророков В.В., Николаев А.В., Власов О.А. Хирургическое лечение рака ободочной кишки: анализ отдаленных результатов // Онкологическая колопроктология. - 2012. - № 1. - С. 24-27. [Prorokov VV, Nikolayev AV, Vlasov OA. Surgical treatment of colon cancer: analysis of long-term outcome. Colorectal oncology. 2012;(1):24-27. (In Russ.)]
  5. Bartley AN, Hamilton SR, Alsabeh R, et al. Template for reporting results of biomarker testing of specimens from patients with carcinoma of the colon and rectum. Arch Pathol Lab Med. 2014;138(2):166-170. doi: 10.5858/arpa.2013-0231-CP.
  6. Раскин Г.А., Петров С.В. Низкий уровень пролиферации - неблагоприятный прогностический признак при аденокарциноме толстой кишки // Казанский медицинский журнал. - 2014. - Т. 95. - № 3. - С. 378-382. [Raskin GA, Petrov SV. Low proliferative level is a poor prognostic factor for colon adenocarcinoma. Kazan Med Zh. 2014;95(3):378-382. (In Russ.)]
  7. Hayashi H, Beppu T, Sakamoto Y, et al. Prognostic value of Ki-67 expression in conversion therapy for colorectal liver-limited metastases. Am J Cancer Res. 2015;5(3):1225-1233.
  8. Pap Z, Ilyes IA, Mocan SL, et al. Changes in immunoexpression of p53, Ki-67, Ets-1, APAF-1 and PTEN in serrated and conventional colon adenomas. Rom J Morphol Embryol. 2015;56(4):1389-1396.
  9. Ковтун Д.П., Аничков Н.М., Полушин О.Г., и др. Особенности патологоанатомической диагностики колоректального рака в онкохирургической клинике (обзор литературы) // Поволжский онкологический вестник. - 2018. - № 1. - С. 59-67. [Kovtun DP, Anichkov NM, Polushin OG, et al. The features of pathological diagnosis of colorectal cancer in oncosurgical clinic (review). Povolzhskii onkologicheskii vestnik. 2018;(1):59-67. (In Russ.)]
  10. Kriegsmann M, Warth A. What is better/reliable, mitosis counting or Ki67/MIB1 staining? Transl Lung Cancer Res. 2016;5(5):543-546. doi: 10.21037/tlcr.2016.10.11.



Abstract - 176

PDF (Russian) - 7


Article Metrics

Metrics Loading ...




  • There are currently no refbacks.

Copyright (c) 2018 Kovtun D.P., Anichkov N.M., Polushin O.G., Ponomaryeva E.V., Lyubimov A.I., Kalinina E.Y.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies