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Interobserver Variability of Ki-67 Measurement in Breast Cancer

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Author(s)
Yul Ri ChungMin Hye JangSo Yeon ParkGyungyub GongWoo-Hee JungThe Korean Breast Pathology Ki-67 Study Group
Keimyung Author(s)
Kwon, Sun Young
Department
Dept. of Pathology (병리학)
Journal Title
Journal of Pathology and Translational Medicine.
Issued Date
2016
Volume
50
Issue
2
Keyword
Ki-67Observer variationMulticenterBreast neoplasms
Abstract
Background: As measurement of Ki-67 proliferation index is an important part of breast cancer
diagnostics, we conducted a multicenter study to examine the degree of concordance in Ki-67
counting and to find factors that lead to its variability. Methods: Thirty observers from thirty different
institutions reviewed Ki-67–stained slides of 20 different breast cancers on whole sections
and tissue microarray (TMA) by online system. Ten of the 20 breast cancers had hot spots of Ki-
67 expression. Each observer scored Ki-67 in two different ways: direct counting (average vs. hot
spot method) and categorical estimation. Intraclass correlation coefficient (ICC) of Ki-67 index
was calculated for comparative analysis. Results: For direct counting, ICC of TMA was slightly
higher than that of whole sections using average method (0.895 vs 0.858). The ICC of tumors
with hot spots was lower than that of tumors without (0.736 vs 0.874). In tumors with hot spots,
observers took an additional counting from the hot spot; the ICC of whole sections using hot
spot method was still lower than that of TMA (0.737 vs 0.895). In categorical estimation, Ki-67 index
showed a wide distribution in some cases. Nevertheless, in tumors with hot spots, the range
of distribution in Ki-67 categories was decreased with hot spot method and in TMA platform.
Conclusions: Interobserver variability of Ki-67 index for direct counting and categorical estimation
was relatively high. Tumors with hot spots showed greater interobserver variability as opposed to
those without, and restricting the measurement area yielded lower interobserver variability.
Keimyung Author(s)(Kor)
권선영
Publisher
School of Medicine
Citation
Yul Ri Chung et al. (2016). Interobserver Variability of Ki-67 Measurement in Breast Cancer. Journal of Pathology and Translational Medicine., 50(2), 129–137. doi: 10.4132/jptm.2015.12.24
Type
Article
ISSN
2383-7837
DOI
10.4132/jptm.2015.12.24
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33224
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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