Ki67 Immunohistochemistry Quantification in Breast Carcinoma: A Comparison of Visual Estimation, Counting, and ImmunoRatio
| Autor: | Caroline Dickens, Eunice van den Berg, Maureen Joffe, Raquel Duarte, Reena Dhansukh Mohanlal |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Histology Mitotic index Proliferation index Receptor ErbB-2 Breast Neoplasms Article Pathology and Forensic Medicine Correlation 03 medical and health sciences 0302 clinical medicine Mitotic Index Medicine Humans Visual estimation business.industry Immunohistochemistry Subtyping Molecular analysis Medical Laboratory Technology 030104 developmental biology Ki-67 Antigen 030220 oncology & carcinogenesis Female Nuclear medicine business Breast carcinoma |
| Zdroj: | Appl Immunohistochem Mol Morphol |
| ISSN: | 1533-4058 |
| Popis: | BACKGROUND: Molecular analysis has shown that breast carcinomas can be classified into several intrinsic subtypes, with implications for management and prognosis. In the majority of pathology laboratories molecular analysis of each case is not possible and immunohistochemistry is used for subtyping. This includes analysis of hormone receptors as well as HER-2-neu and Ki67. The methodology for the interpretation of the proliferation index using Ki67 remains an area of uncertainty. We investigated the degree of agreement between different methods of Ki67 interpretation. MATERIALS AND METHODS: We analysed 204 breast core biopsies diagnostic of breast carcinoma using visual estimation/eyeballing (EB), Immunoratio©(IR), and counting by two pathologists (CP1 and CP2). The correlation between the different methods and the inter-observer agreement between the two pathologists was assessed. Specific analysis was also done with respect to classification of cases into low Ki67 groups (using Ki67 values less than 14% and less than 20%) since this is critical in classifying tumours into Luminal A and Luminal B subtypes. RESULTS: Correlation between the different methods was best achieved comparing IR and CP1, and worst comparing CP1 and EB. Correlation was better when considering inter-observer variability (CP1 vs CP2). Comparing the number of cases classified as low Ki67 (less than 14% and less than 20%) the Cohen’s Kappa statistic varied from κ = 0.267 to κ = 0.814 with different methods. When limiting the analysis to cases with a Ki67 of 10–25% according to any method, there was greater disagreement. CONCLUSION: At the higher and lower Ki67 levels, the correlation between the methods of assessment was acceptable, however, at levels close to the cut-off values for Lumial A versus Luminal B, several patients would be differently classified by the different methods and therefore potentially receive suboptimal management. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|