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. 2000 Jan;84(1):98–102. doi: 10.1136/bjo.84.1.98

Effects of proton beam irradiation on uveal melanomas: a comparative study of Ki-67 expression in irradiated versus non-irradiated melanomas

C Chiquet 1, J Grange 1, L Ayzac 1, P Chauvel 1, L Patricot 1, M Devouassoux-Shish 1
PMCID: PMC1723230  PMID: 10611107

Abstract

AIMS—To assess the cellular proliferation using the monoclonal antibody Ki-67, in paraffin embedded uveal melanomas irradiated by proton beam, as well as in non-irradiated uveal melanomas.
METHODS—30 enucleated eyes were included for histopathological study and Ki-67 immunostaining. Patients were enucleated between 1991 and 1996 for uveal melanoma, 14 after proton beam irradiation and 16 without treatment (control group). The mean follow up period was 2.5 years after diagnosis and 1 year after enucleation.
RESULTS—A significant relation was found between Ki-67 score and mitotic index (r = 0.56, p = 0.001), histological largest tumour diameter (r = 0.38, p = 0.03), fibrosis (r = −0.35, p = 0.05), absence of tumoral pigmentation (p = 0.05), and presence of vascular thrombosis (p = 0.03). The Ki-67 score was significantly higher in the non-irradiated group (p = 0.01) and in the group of patients whose cause of enucleation was tumoral evolution (p = 0.005) compared with the group of patients enucleated after neovascular glaucoma. The Ki-67 score was very high in a case of orbital recurrence of uveal melanoma and metastatic death. 70% of metastasised tumours showed a Ki-67 score higher than the median value.
CONCLUSION—Ki-67 labelling is a reliable method of estimating the proliferative activity in uveal melanomas after proton beam irradiation. The Ki-67 score is significantly correlated with prognostic variables (mitotic index and histological largest tumour diameter), and with radiation effects after proton beam irradiation.



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Figure 1  .

Figure 1  

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Ki-67 immunostaining in an irradiated choroidal spindle cell melanoma. Note the speckled red nuclear and nucleolar staining (arrows) readily distinguished from the brown endogenous melanin pigment (stars) (original magnification ×1000).

Figure 2  .

Figure 2  

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Mitotic figures plotted against Ki-67 positive cells for 30 eyes. Filled symbols represent data for tumours treated by proton beam irradiation and open symbols, data for non-irradiated tumours. The mitotic figures and Ki-67 immunoreactive cells were counted in 40 high power fields (HPFs).

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