Interobserver concordance of Ki67 labeling index in breast cancer: Japan Breast Cancer Research Group Ki67 Ring Study |
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| Authors: | Kenichi Yoshimura Hitoshi Tsuda Masafumi Kurosumi Shinobu Masuda Rie Horii Masakazu Toi Hironobu Sasano |
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| Affiliation: | 1. Translational Research Center, Kyoto University Hospital, , Kyoto, Japan;2. Diagnostic Pathology Section, Clinical Laboratory Division, National Cancer Center Hospital, , Tokyo, Japan;3. Department of Pathology, Saitama Cancer Center, , Saitama, Japan;4. Department of Pathology, Nihon University School of Medicine, , Tokyo, Japan;5. Department of Pathology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, , Tokyo, Japan;6. Department of Breast Surgery, Kyoto University Hospital, , Kyoto, Japan;7. Department of Pathology, Tohoku University School of Medicine, , Sendai, Japan |
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| Abstract: | The standardized assessment of Ki67 labeling index (LI) is of clinical importance to identify patients with primary breast cancer who could benefit from chemotherapy. In this study, we evaluated the interobserver concordance of Ki67 LI assessment. Six surgical pathologists participated and all the slides were prepared from archival breast cancer tissues fixed in 10% buffered formalin for 24 h and stained with MIB‐1. Three independent studies were conducted. In the first study, 30 stained slides were assessed using two different methods: the scoring system, with a positive rate scored from 1 (0–9%) to 10 (90–100%) by visual estimate; and the counting method, with approximately 1000 cells counted in hot spots. In the second study, 20 tumors with Ki67 LI 5–25% were assessed, and in the third study, 15 printed photographs of stained slides were assessed to avoid variations by selecting different fields. In study 1, the counting system (intraclass correlation coefficient [ICC], 0.66 [95% confidence interval 0.52–0.78]) demonstrated a better correlation than the scoring system (ICC, 0.57 [0.42–0.72]). In study 2, the assessment for Ki67 LI of 5–25% demonstrated a correlation (ICC, 0.68 [0.50–0.81]) similar to that of study 1 (unrestricted range of Ki67 LI). In study 3, the assessment of Ki67 LI by counting yielded a good concordance (ICC, 0.94 [0.88–0.97]). In conclusion, there was better concordance with the counting system, and concordance was high when the assessed field was predetermined, indicating that the selection of the evaluation area is critical for obtaining reproducible Ki67 LI in breast cancer. |
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