Abstract:
CONTEXT:- Pathologists routinely assess Ki67 immunohistochemistry to grade gastrointestinal and pancreatic neuroendocrine tumors. Unfortunately, manual counts of the Ki67 index are very time consuming and eyeball estimation has been criticized as unreliable. Manual Ki67 counts performed by cytotechnologists could potentially save pathologist time and improve accuracy. OBJECTIVE:- To assess the concordance between manual Ki67 index counts performed by cytotechnologists versus eyeball estimates and manual Ki67 counts by pathologists. DESIGN:- One Ki67 immunohistochemical stain was retrieved from each of 18 archived gastrointestinal or pancreatic neuroendocrine tumor resections. We compared pathologists' Ki67 eyeball estimates on glass slides and printed color images with manual counts performed by 3 cytotechnologists and gold standard manual Ki67 index counts by 3 pathologists. RESULTS:- Tumor grade agreement between pathologist image eyeball estimate and gold standard pathologist manual count was fair (κ = 0.31; 95% CI, 0.030-0.60). In 9 of 20 cases (45%), the mean pathologist eyeball estimate was 1 grade higher than the mean pathologist manual count. There was almost perfect agreement in classifying tumor grade between the mean cytotechnologist manual count and the mean pathologist manual count (κ = 0.910; 95% CI, 0.697-1.00). In 20 cases, there was only 1 grade disagreement between the 2 methods. Eyeball estimation by pathologists required less than 1 minute, whereas manual counts by pathologists required a mean of 17 minutes per case. CONCLUSIONS:- Eyeball estimation of the Ki67 index has a high rate of tumor grade misclassification compared with manual counting. Cytotechnologist manual counts are accurate and save pathologist time.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Cottenden J,Filter ER,Cottreau J,Moore D,Bullock M,Huang WY,Arnason Tdoi
10.5858/arpa.2017-0203-OAsubject
Has Abstractpub_date
2018-03-01 00:00:00pages
402-407issue
3eissn
0003-9985issn
1543-2165journal_volume
142pub_type
杂志文章abstract:CONTEXT.—:The College of American Pathologists guidelines recommend testing additional tumor foci in multifocal invasive breast carcinomas for the biomarkers estrogen receptor (ER), progesterone receptor, and HER2 only if the carcinomas show different morphologies or grades. OBJECTIVE.—:To assess clinical significance...
journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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doi:
更新日期:1994-03-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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