IHC single marker with reporting Ki 67

Cancer

Report in 144Hrs

At Home

No Fasting Required

Details

Tumor marker staining.

₹2,738₹3,911

30% OFF

IHC Single Marker with Reporting Ki-67: Comprehensive Medical Test Guide

Section 1: Why is it done?
- Test Purpose: IHC (Immunohistochemistry) single marker with Ki-67 reporting is used to detect and quantify cell proliferation in tissue samples. Ki-67 is a nuclear protein expressed in actively dividing cells throughout the cell cycle, making it an essential marker for assessing tumor grade and aggressiveness.
- Primary Indications for Testing: Evaluation of suspected malignancies (breast, prostate, lymphomas, sarcomas, and other cancers); Assessment of tumor grade and prognosis; Differentiation of benign from malignant lesions; Monitoring treatment response; Predicting clinical outcome and survival; Risk stratification for prognostic purposes
- Typical Timing and Circumstances: Performed on tissue samples obtained via biopsy (core needle, excisional, incisional) or surgical resection specimens; Typically ordered at the time of initial cancer diagnosis; May be repeated during disease monitoring or when assessing recurrent lesions; Useful in neoadjuvant and adjuvant therapy planning; Often combined with other immunohistochemical markers for comprehensive tumor characterization
Section 2: Normal Range
- Reference Range Values: Ki-67 Index is expressed as a percentage (0-100%) of positively stained nuclei among total nuclei counted; Normal benign tissues typically show Ki-67 index <5-10%; Low Ki-67 index: <20% (generally favorable prognosis); Intermediate Ki-67 index: 20-40% (variable prognostic significance); High Ki-67 index: >40% (associated with aggressive behavior and worse prognosis); Specific thresholds vary by tissue type and cancer (e.g., breast cancer cutoff commonly 14-20%, lymphomas may use different criteria)
- Units of Measurement: Ki-67 proliferation index reported as percentage (%); Number of positive cells per total cells counted; May also be reported qualitatively as low, intermediate, or high expression
- Result Interpretation Guidelines: Negative/Low Ki-67 (<5-10%): Suggests low cell proliferation, consistent with benign lesions or low-grade malignancies; Associated with better prognosis; May indicate favorable treatment response; Borderline/Intermediate Ki-67 (20-40%): Intermediate level of cell proliferation; Requires integration with other clinical and pathologic features for prognostic assessment; High Ki-67 (>40%): Indicates significant cell proliferation and increased aggressiveness; Correlates with poorer prognosis and need for aggressive therapy; Associated with higher likelihood of metastasis and recurrence
Section 3: Interpretation
- Detailed Result Value Interpretation: Ki-67 Index <5%: Suggests normal tissue or benign proliferation; Typically seen in non-neoplastic conditions; Low malignant potential if present in tumor tissue; Ki-67 Index 5-10%: Borderline low proliferation; May indicate low-grade neoplasm or regressing lesion; Generally favorable outlook; Ki-67 Index 10-20%: Low-intermediate proliferation; Consistent with low-grade malignancy; Better prognosis than higher indices; Ki-67 Index 20-40%: Intermediate proliferation rate; Associated with variable clinical outcomes; Requires multi-parameter analysis for prognosis; Ki-67 Index >40%: High proliferation rate; Indicates aggressive neoplasm; Poor prognostic indicator; Strongly suggestive of high-grade malignancy; Associated with reduced survival and rapid progression
- Clinical Significance of Result Patterns: Uniform high Ki-67 distribution suggests aggressive, rapidly dividing tumor; Heterogeneous Ki-67 staining may indicate tumor heterogeneity or mixed populations of proliferating and quiescent cells; Areas of necrosis typically show low/absent Ki-67; Peripheral tumor zones often show higher Ki-67 than central regions; Progressive increase in Ki-67 suggests tumor progression; Decrease in Ki-67 following therapy indicates treatment response
- Factors Affecting Ki-67 Measurements: Tissue fixation quality and duration; Antigen retrieval techniques used; Antibody quality and lot variations; Staining methodology and equipment; Counting methodology (manual vs automated); Area selected for assessment (tumor center vs periphery); Background inflammation and immune cell infiltration; Specimen handling and processing delays; Prior therapy effects on residual tumor cells; Timing of biopsy relative to treatment
- Disease-Specific Interpretation: Breast cancer: Ki-67 >20% indicates poorer prognosis, guides chemotherapy decisions; Lymphomas: Ki-67 used for grading and risk stratification; Soft tissue sarcomas: Higher Ki-67 correlates with grade and survival; Prostate cancer: Ki-67 helps predict progression and therapy response; Endometrial cancer: Assists in grade determination and prognostic assessment; Colorectal cancer: High Ki-67 associates with worse outcomes
Section 4: Associated Organs
- Primary Organ Systems Involved: Universal applicability - Ki-67 IHC can be used on tissue from any organ system; Most commonly applied to: Breast tissue; Lymphoid tissues (lymph nodes, spleen); Soft tissue and bone; Gastrointestinal tract; Genitourinary organs; Central nervous system; Endocrine glands
- Conditions Associated with Abnormal Results: Elevated Ki-67 (>20-40%): Breast cancer (invasive ductal and lobular carcinomas); Lymphomas (high-grade types); Sarcomas and other mesenchymal tumors; Gastric and colorectal adenocarcinomas; High-grade gliomas; Melanomas; Neuroendocrine carcinomas; Hepatocellular carcinoma; Ovarian and endometrial cancers; Low Ki-67 (<10%): Low-grade lymphomas; Low-grade sarcomas; Benign lesions and hyperplastic conditions; Well-differentiated carcinomas; Fibromas and other benign tumors
- Diseases This Test Helps Diagnose/Monitor: Malignant tumors (all histologic types); Grade determination of neoplasms; Tumor classification and risk stratification; Differentiation of benign from malignant lesions; Transformed lymphomas; Recurrent or residual disease; Treatment response assessment; Metastatic disease characterization; Borderline or atypical lesion interpretation
- Complications and Risks Associated with Abnormal Results: High Ki-67 results indicate: Aggressive malignancy requiring intensive treatment; Risk of rapid disease progression; Potential for early metastasis; Requirement for multimodal therapy; Possible chemotherapy resistance; Shorter overall and disease-free survival; Need for close clinical monitoring and follow-up; Risk of treatment-related toxicities with aggressive therapy; Psychological impact of unfavorable prognosis; Impact on quality of life during treatment
Section 5: Follow-up Tests
- Complementary Immunohistochemical Markers: ER/PR (Estrogen and Progesterone Receptors) for breast cancer; HER2 expression assessment; CD20, CD5, CD23 for lymphoma classification; p53 for tumor suppressor function; Cyclin E for additional proliferation assessment; PCNA for proliferation index confirmation; Tissue-specific markers (PSA for prostate, CEA for colorectal); Apoptosis markers (caspase-3); Hypoxia markers (HIF-1α, pimonidazole)
- Additional Tests Recommended Based on Results: High Ki-67 findings: Molecular testing (gene expression profiling, genomic sequencing); Flow cytometry for hematologic malignancies; Fluorescence in-situ hybridization (FISH) for specific gene abnormalities; Additional tumor marker assays; Low Ki-67 findings: Conservative management may be considered; Less frequent imaging surveillance; Reduced treatment intensity in some cases
- Further Investigations Based on Clinical Context: Staging studies: CT chest/abdomen/pelvis; PET-CT for metabolic activity assessment; Bone scan or bone marrow biopsy; Brain MRI if CNS involvement suspected; Molecular profiling for mutation status; NGS panels for actionable mutations; Mitotic count assessment; Histologic grade confirmation
- Monitoring Frequency for Ongoing Conditions: High Ki-67 tumors: Clinical exams every 3-4 months during treatment; Imaging studies every 3-6 months based on cancer type; Tumor marker monitoring if applicable; Post-treatment surveillance every 6-12 months initially, then annually; Low Ki-67 tumors: Less frequent clinical assessments (every 6-12 months); Annual imaging in most cases; Long-term surveillance based on cancer type and stage
- Repeat Testing Indications: Recurrent disease assessment; Biopsy of new lesions; Evaluation of treatment response; Monitoring for transformation (e.g., low-grade to high-grade lymphoma); Assessment of residual disease after chemotherapy; Evaluation of metastatic disease; Confirmation of initial diagnosis if clinically indicated
Section 6: Fasting Required?
- Fasting Requirement: NO - Fasting is NOT required for this test.
- Explanation: IHC single marker with Ki-67 reporting is performed on tissue samples, not blood; The test involves immunohistochemical staining of fixed tissue obtained through biopsy or surgical resection; Food and beverage intake do not affect tissue-based testing; Patient metabolic state is irrelevant to Ki-67 immunostaining results
- Patient Preparation Requirements: For biopsy procedure: Local or general anesthesia may be used depending on biopsy type and location; Follow specific pre-procedure instructions provided by the medical team; Discontinue blood thinners if instructed (aspirin, warfarin, NSAIDs) - typically 3-7 days prior; Arrange transportation if sedation will be used; Nothing to eat or drink if conscious sedation is planned (typically 6-8 hours); Wear comfortable, easily removable clothing; Inform healthcare providers of all medications and allergies; Post-procedure: Rest as recommended; Follow wound care instructions; Avoid strenuous activity for 24-48 hours as directed; Take prescribed pain management as needed; Contact provider if excessive bleeding, infection signs, or complications develop
- Medications and Special Instructions: Continue routine medications unless specifically directed otherwise; Blood thinners (warfarin, dabigatran, apixaban, rivaroxaban): Discontinue 3-7 days before biopsy; Aspirin and NSAIDs: Typically held 5-7 days pre-biopsy; Antiplatelet agents: Coordinate timing with prescribing physician; Herbal supplements (ginkgo, garlic, ginger): May need discontinuation; Provide complete medication list to biopsy team; Report allergies to anesthetics, antibiotics, or iodine; Maintain normal hydration status unless instructed otherwise
- Specimen Handling Considerations: Tissue must be properly fixed immediately after collection (typically in 10% neutral buffered formalin); Fixation time should be standardized (usually 6-24 hours); Adequate fixation is essential for accurate Ki-67 staining; Rapid processing improves antigen preservation; Delayed processing may affect staining quality and results; Specimen labeling must be accurate to prevent errors; Chain of custody documentation is required; Special transport containers may be needed for certain specimens

How our test process works!