In this issue, Lee et al. [1] present a provocative study examining Ki-67 proliferation index (MIB-1) and its correlation to overall survival in patients with gastric cancer. They immunostained 245 paraffin embedded tissue samples from patients with gastric cancer and correlated the findings with clinicopathologic characteristics including histologic type, TNM staging, EMT-related proteins, and overall survival. They conclude that a high Ki-67 proliferation index translates into improved survival, which is in contradistinction to multiple previous studies that have documented the exact opposite. The thought that a higher proliferation index means a tumor is less likely to metastasize is counterintuitive to many. Although the data presented by Lee et al. will not settle the debate, it certainly shines new light on the controversy.
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