Distribution pattern of the Ki67 labelling index in breast cancer and its implications for choosing cut-off values |
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| Affiliation: | 1. Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary;2. Department of Pathology, University of Szeged, Hungary;3. Pathology Centre, Riga East Clinical University Hospital, Riga, Latvia;4. Section of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, AOU Careggi, Largo GA Brambilla 3, 50134 Florence, Italy;5. Department of Pathology, Skåne University Hospital, Lund, Sweden;6. Department of Medical Sciences, University of Turin, Italy;7. Medical University of Graz, Institute of Pathology, Auenbruggerplatz 25, A-8036 Graz, Austria;8. Department of Biomedical and Neuromotor Sciences, University of Bologna, Anatomic Pathology at Bellaria Hospital, Via Altura, 3, 40139 Bologna, Italy;9. Department of Pathology, Medical School, University of Patras, Rion, Patras, Greece;10. Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland;11. Lab Histopatologia, Av Bissaya Barreto, Apartado 2005, 3001-651 Coimbra, Portugal;12. Department of Pathology, Dietrich Bonhoeffer Medical Centre, Allendestraße 30, D-17036 Neubrandenburg, Germany;13. 2nd Department of Pathology, Semmelweis University Budapest, Üllői út 93, H-1091 Budapest, Hungary;14. Marmara University School of Medicine, Department of Pathology, Istanbul, Turkey;15. Institute of Pathology, Danube Hospital, Langobardenstrasse 122, A-1220 Vienna, Austria;p. Department of Pathology, Centro Hospitalar de S. João and Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Portugal;q. Discipline of Pathology, NUI Galway, Galway, Ireland;r. Department of Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;s. Department of Molecular Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;t. Department of Pathology, University College Hospital, London, United Kingdom;1. ELI-ALPS, ELI-HU Non-Profit Ltd., Dugonics tér 13, H-6720 Szeged, Hungary;2. Department of Theoretical Physics, University of Szeged, Tisza L. krt. 84-86, H-6720 Szeged, Hungary;3. Wigner Research Center for Physics, SZFI, PO Box 49, H-1525 Budapest, Hungary;1. Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China;2. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China;3. Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China;1. Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile;2. Servicio de Dermatología, Hospital Clínico Universidad de Chile, Santiago, Chile;1. Department of Surgery, Máxima Medical Centre, Veldhoven/Eindhoven, The Netherlands;2. Netherlands Cancer Registry, Eindhoven, The Netherlands;3. Maastricht University Medical Centre, School GROW, Maastricht, The Netherlands;1. College of Materials and Chemical Engineering, Hubei Provincial Collaborative Innovation Center for New Energy Microgrid, Collaborative Innovation Center for Energy Equipment of Three Gorges Region, China Three Gorges University, Yichang 443002, China;2. Three Gorges Center for Product Quality Control, Yichang 443002, China;3. School of Physical Science and Technology, Key Laboratory of Artificial Micro/Nano-Structures of the Ministry of Education, Wuhan University, Wuhan 430072, China |
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| Abstract: | The Ki67 labelling index (LI – proportion of staining cells) is widely used to reflect proliferation in breast carcinomas. Several cut-off values have been suggested to distinguish between tumours with low and high proliferative activity. The aim of the current study was to evaluate the distribution of Ki67 LIs in breast carcinomas diagnosed at different institutions by different pathologists using the method reflecting their daily practice. Pathologists using Ki67 were asked to provide data (including the LI, type of the specimen, receptor status, grade) on 100 consecutively stained cases, as well as details of their evaluation. A full dataset of 1709 carcinomas was collected from 19 departments. The median Ki67 LI was 17% for all tumours and 14% for oestrogen receptor-positive and HER2-negative carcinomas. Tumours with higher mitotic counts were associated with higher Ki67 LIs. Ki67 LIs tended to cluster around values ending with 5 or 0 both in cases where the values were obtained by counting the proportion of stained tumour cell nuclei and those where the values were obtained by estimation. On the basis of the distribution pattern described, some currently used Ki67 LI cut off values are not realistic, and it is proposed to select more realistic values ending with 0 or 5. |
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| Keywords: | Ki67 Proliferation Breast cancer |
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