Research Article

Comparasion Between Mitotic Activity, Ki-67 Index and Platelet Volume Index as a Prognostic Marker in Gliablastomas


  • Tolga Turan Dündar

Received Date: 11.03.2019 Accepted Date: 29.05.2019 J Ankara Univ Fac Med 2019;72(2):222-226


An elevated platelet count is considered an independent prediction of survey in glioblastoma and various other intracranial entities. Activity of the tumor microcirculation resulting in platelet activation and release of several cytokines and factors from activated platelets has been suggested to play an active role in neuro-inflammation. Ki-67 index and mitotic activity are markers which could be showed proliferation in the glial tumor. High Ki-67 expression and mitosis rate of high grade glial tumors have been more aggressive clinical progression, poor prognosis, more vascular invasion than low. Recently, Mean Platelet Volume (MPV) to platelet count (PLT) ratio has become a trend indicator to anticipate the outcome of a patient suffering from intracranial pathologies. The study aims to determine first time whether the comparison of the Volume Index (PVI) as an immune response marker with the Ki-67 and mitotic activity could be used as a prognostic factor in gliablastoma (WHO Grade IV).

Materials and Methods:

In the retrospective study, we studied 65 patients diagnosed with glioblastoma who had inclusion and exclusion criteria. The correlation between PVI, Ki-67 and mitotic activity was examined all cases after pathologically diagnosed, by the routine processes of the pathological preparates. PVI was calculated from pre-operative first complete blood count (CBC) and was defined as MPV value (fL)x100/PLT (per 1000). The Kolmogorov-Smirnov test and Spearman’s correlation coefficient was used in the analysis of the interrelationship.


The correlation between the PVI, Ki-67 and mitotic index was found to be leak statistically correlation.


It was determined that PVI is decreased, Ki-67 immunoreactivity and mitotic index are increased. The PVI may be used as a prognostic, predictive factor for glioblastoma. Nevertheless, further studies concerning the prognosis of glioblastoma are needed to confirm this hypothesis.

Keywords: Glioblastoma, GBM, Platelets, Mean Platelet Volume, Platelet Volume Index, PVI

Full Text (Turkish)