Association of Ki-67 Level on Bone Destruction in Chronic Suppurative Otitis Media Patients with Cholesteatoma

Abstract

Background: Chronic suppurative otitis media (CSOM) with cholesteatoma is one of the most common chronic infections found in developing countries. Cholesteatoma will stimulate bone resorption from the epithelial and stromal cells resulting in cytokine and keratinocyte formation, as well as mastoid bone destruction. The Ki-67 found in the proliferating cell shows that this protein plays an important role as a cell division process marker. Objective: Analyzing the association of Ki-67 on bone destruction in CSOM with cholesteatoma. Method: Participants in this study were CSOM patients with cholesteatoma who underwent surgery. Participants were assessed for bone destruction based on CT scan examination and confirmed during surgery. Examination of Ki-67 levels was carried out by taking cholesteatoma tissue at the time of surgery and analyzed using the ELISA method. The results of the examination were analyzed using the Spearman's rank correlation, Pearson’s correlation and logistic regression with p < 0.05. Results: The value of Ki-67 levels at each degree of destruction was degree 1 of 0.301, degree 2 of 0.36 ± 0.34, degree 3 of 0.41 ± 0.07, degree 4 of 0.60 ± 0.85, degree 5 of 0.74 ± 0.12, and degree 6 equal to 0.90 (r = 0.906; p = 0.001). In addition, there was a significant relationship between symptoms duration on bone destruction (r = 0.913; p = 0.001) and levels of Ki-67 (r = 0.887; p < 0.001). The regression coefficient was 0.079 for the independent variable, bone destruction with p = 0.009, and the regression coefficient 0.024 for symptoms duration with p = 0.014. Conclusion: Increased Ki-67 level in cholesteatoma is associated with bone destruction degree in CSOM patients with cholesteatoma.