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Endocrine Pathology

, Volume 30, Issue 1, pp 17–23 | Cite as

Comparison of Monitor-Image and Printout-Image Methods in Ki-67 Scoring of Gastroenteropancreatic Neuroendocrine Tumors

  • Fatih Mert DogukanEmail author
  • Banu Yilmaz Ozguven
  • Rabia Dogukan
  • Fevziye Kabukcuoglu
Article

Abstract

Gastroenteropancreatic neuroendocrine tumors (GEP-NET) are classified according to tumor grade. Ki-67 and mitotic count are the two determinants of this classification. Therefore, Ki-67 scoring becomes very important in classifying the patients accurately. Eye-balling, counting of cells through the microscope, automated image analysis systems, and manual counting of printed image are the four major scoring methods in use. The aim of this study is to show the agreement between monitor-image method (MIM) and printout-image method (PIM) of Ki-67 scoring. In our study, 120 GEP-NETs from 85 patients diagnosed between January 2005 and July 2017 were evaluated. Thirty-seven cases with either polypectomy or resection material were selected. Seven different scoring methods using either a monitor-image or a printout-image were applied for Ki-67 scoring. They are as follows: whole-PIM, 1/9-PIM, whole-MIM, 1/4-MIM, 1/6-MIM, 1/9-MIM, and 1/12-MIM. In the comparison of Ki-67 scoring methods, intraclass correlation coefficients ranging from 0.951 to 0.999 were found. The Bland-Altman analysis showed near-perfect agreement between whole-MIM and whole-PIM as well as 1/9-MIM and 1/9-PIM. The level of agreements among the other methods were sufficient too, but there was a relative decrease in the level of agreement as the area of counting becomes smaller. The average application time decreased from 373.7 to 41.7 s gradually as the scoring area becomes smaller. Our study shows that there is a remarkable agreement between the MIM and PIM used in Ki-67 scoring.

Keywords

Neuroendocrine tumors Ki-67 Gastrointestinal neoplasms Pancreatic neoplasms Tumor grading 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO Classification of Tumours of the Digestive System, 4th edn. International Agency for Research on Cancer, Lyon.Google Scholar
  2. 2.
    Klöppel G, Couvelard A, Hruban RH, Klimstra DS, Komminoth P, Osamura RY, et al (2017) Neoplasms of the neuroendocrine pancreas. In: Lloyd RV, Osamura RY, Klöppel G, Rosai J (ed) WHO Classification of Tumours of Endocrine Organs, 4th edn. International Agency for Research on Cancer, Lyon.Google Scholar
  3. 3.
    Klöppel G, Rindi G, Perren A, Komminoth P, Klimstra D (2010) The ENETS and AJCC/UICC TNM classifications of the neuroendocrine tumors of the gastrointestinal tract and the pancreas: a statement. Virchows Arch 456(6):595–597.  https://doi.org/10.1007/s00428-010-0924-6.CrossRefPubMedGoogle Scholar
  4. 4.
    Rindi G, Klimstra DS, Abedi-Ardekani B, Asa SL, Bosman FT, Brambilla E, Busam KJ, de Krijger RR, Dietel M, el-Naggar AK, Fernandez-Cuesta L, Klöppel G, McCluggage WG, Moch H, Ohgaki H, Rakha EA, Reed NS, Rous BA, Sasano H, Scarpa A, Scoazec JY, Travis WD, Tallini G, Trouillas J, van Krieken JH, Cree IA (2018) A common framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol.  https://doi.org/10.1038/s41379-018-0110-y
  5. 5.
    Shi C, Adsay V, Bergsland EK, Berlin J, Branton PA, Fitzgibbons PL, et al (2017) Protocol for the examination of specimens from patients with neuroendocrine tumors (carcinoid tumors) of the stomach. College of American Pathologists Cancer Protocols. www.cap.org/cancerprotocols. Accessed 11 September 2018.
  6. 6.
    Matsukuma K, Olson KA, Gui D, Gandour-Edwards R, Li Y, Beckett L (2017) Synaptophysin-Ki67 double stain: a novel technique that improves interobserver agreement in the grading of well-differentiated gastrointestinal neuroendocrine tumors. Mod Pathol 30(4):620–629.  https://doi.org/10.1038/modpathol.2016.225 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Reid MD, Bagci P, Ohike N, Saka B, Erbarut Seven I, Dursun N, Balci S, Gucer H, Jang KT, Tajiri T, Basturk O, Kong SY, Goodman M, Akkas G, Adsay V (2015) Calculation of the Ki67 index in pancreatic neuroendocrine tumors: a comparative analysis of four counting methodologies. Mod Pathol 28(5):686–694.  https://doi.org/10.1038/modpathol.2014.156.CrossRefPubMedGoogle Scholar
  8. 8.
    Tang LH, Gonen M, Hedvat C, Modlin IM, Klimstra DS (2012) Objective quantification of the Ki67 proliferative index in neuroendocrine tumors of the gastroenteropancreatic system: a comparison of digital image analysis with manual methods. Am J Surg Pathol 36(12):1761–1770.  https://doi.org/10.1097/PAS.0b013e318263207c CrossRefPubMedGoogle Scholar
  9. 9.
    Remes SM, Tuominen VJ, Helin H, Isola J, Arola J (2012) Grading of neuroendocrine tumors with Ki-67 requires high-quality assessment practices. Am J Surg Pathol 36(9):1359–1363.  https://doi.org/10.1097/PAS.0b013e3182632038.CrossRefPubMedGoogle Scholar
  10. 10.
    Adsay V (2012) Ki67 labeling index in neuroendocrine tumors of the gastrointestinal and pancreatobiliary tract. Am J Surg Pathol 36(12):1743–1746.  https://doi.org/10.1097/PAS.0b013e318272ff77.CrossRefPubMedGoogle Scholar
  11. 11.
    Cottenden J, Filter ER, Cottreau J, Moore D, Bullock M, Huang WY, Arnason T (2018) Validation of a cytotechnologist manual counting service for the Ki67 index in neuroendocrine tumors of the pancreas and gastrointestinal tract. Arch Pathol Lab Med 142(3):402–407.  https://doi.org/10.5858/arpa.2017-0203-OA.CrossRefPubMedGoogle Scholar
  12. 12.
    Ozturk Sari S, Taskin OC, Yegen G, Ozluk Y, Gulluoglu M (2018) Ki67 scoring in pancreatic neuroendocrine tumors by a new method. Appl Immunohistochem Mol Morphol 26(4):283–287.  https://doi.org/10.1097/PAI.0000000000000415.CrossRefPubMedGoogle Scholar
  13. 13.
    McGraw KO, Wong SP (1996) Forming inferences about some intraclass correlation coefficients. Psychol Methods 1:30–46.  https://doi.org/10.1037/1082-989X.1.1.30.CrossRefGoogle Scholar
  14. 14.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyMardin State HospitalMardinTurkey
  2. 2.Department of PathologyUniversity of Health Sciences Sisli Hamidiye Etfal Education and Research CenterIstanbulTurkey

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