The evaluation of ki-67 monoclonal antibody in renal biopsies of patients with rapidly progressive (crescentic) glomerulonephritis and its effect on prognosis

ABSTRACT INTRODUCTION-AIM: In previous study, renal biopsy samples of patients with Rapidly Progressive (cresentic) glomerulonephritis is evaluated with Ki-67 as a proliferation index, Bcl-2 as a determiner of apoptotic activity and CD-68 as a cellular marker of macrophage, evaluated with immunohistochemistry. Thereby we aimed to determine the effects on cellular proliferation, apoptosis and prognosis of disease. METHODS: Follow up patients in Adnan Menderes University Hospital, Nephrology Clinics since 2008, with diagnosis of crescent formation at renal biopsy samples and who were higher than 18 years old, totally 60 patients were included, and are assessed retrospectively. Paraffin-embedded biopsy samples of patients were evaluated with immunohistochemical stainings of Kİ-67, CD-68 and Bcl-2. For the evaluatıon of research data, SPSS 17 was used for statistical analysis. Statistical significance was considered with p < 0,05. RESULTS: Average of age for women was 56 and for men was 53. İnitial creatinine value for women was significantly lower than men. The most common pathological diagnosis was paucı-ımmun crescentic (58,3%) glomerulonephritis. There were no significant relationship between Ki-67 and Bcl-2 immunohistochemical staining scores with annual creatinin changes. However in the group with +1 score for CD-68 immunohistochemical staining, measurements of creatinine in one year time frame was significantly decreased. Additionally, the group with scores of ≥+2 for CD-68, there were non-significant increase in creatinine values in one year time frame. CONCLUSION: CD-68 immunohistochemical staining is used as a macrophage cell marker, patients with +1 score for CD-68 immunohistochemical staining was found with a better prognosis for one-year kidney survival. There was no significant differences between staining scores of Ki-67 and Bcl-2 with creatinine results in 1 year time frame. However in the group with +1 score for CD-68, measurements of creatinine in 1 year time frame was significantly decreased. We suggest that the prognosis of patients with scores of ≥+2 for CD-68 was worse and this finding refers bad prognosis at patients with rapidly progressive (cresentic) glomerulonephritis. Key words; Bcl-2, CD-68, Ki-67, crescentic glomerulonephritis, creatinine