Volume: 46 Issue: 3
Year: 2026, Page: 183-189, Doi: https://doi.org/10.51248/v46i3.39
Received: April 2, 2026 Accepted: July 11, 2026 Published: Aug. 5, 2026
INTRODUCTION: Ki-67 is a well known marker of cellular proliferation. Its clinico-pathological importance in locally advanced head and neck squamous cell carcinoma (LAHNSCC) is not clearly defined. METHODS: This prospective, observational study included histopathologically confirmed 90 patients with LAHNSCC. Biopsy specimens were assessed for Ki-67 expression using immunohistochemistry, and the labelling index was recorded as a continuous variable. The squamous cell cancers were graded as well-differentiated (WDSCC), moderately differentiated (MDSCC), or poorly differentiated (PDSCC). Differences in Ki-67 expression across histopathological grades were analyzed using one-way analysis of variance (ANOVA) with Tukey’s post hoc testing. RESULTS: The mean age of the cohort was 57.2 years (range 37–74). Histopathological grading revealed 13 (14.4%) WDSCC, 66 (73.3%) MDSCC, and 11 (12.2%) PDSCC cases. Mean Ki-67 expression increased progressively with worsening differentiation: 6.00% in WDSCC, 23.67% in MDSCC, and 78.36% in PDSCC. One-way ANOVA revealed a significant difference across all the grades (F(2,87)=54.04, p<0.001). The Post-hoc analysis showed significant differences between all the differentiation categories (p<0.001). A weak positive correlation was observed between Ki-67 expression and baseline TLC (r=0.147); however, this association did not reach statistical significance (p=0.168). Ki-67 expression did not differ significantly according to tonsillar fossa involvement (p=0.094). CONCLUSIONS: Ki-67 labelling index demonstrates a strong quantitative proliferative gradient across histopathological grades in LAHNSCC, with markedly elevated expression in poorly differentiated cancers. These findings reinforce the role of Ki-67 as an objective marker of cancer proliferative activity and histological aggressiveness in advanced-stage disease.
Keywords: Proliferation, Head and Neck, Tonsillar Fossa, Expression
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Abhishek Soni, Ashok Chauhan, Baljit Singh, Prateek Jangra, Paramjeet Kaur, Rajeev Atri, Rakesh Dhankhar. Association of Ki-67 Proliferation Index with Histopathological Differentiation in Locally Advanced Head and Neck Squamous Cell Carcinoma. Biomedicine: 2026, 46(3): 183-189. https://doi.org/10.51248/v46i3.39