Her2 negative luminal breast carcinoma and Ki-67 evaluation
Her2 negative luminal breast carcinoma and Ki-67 evaluation
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DOI：
10.1016/j.breast.2012.04.004
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发表时间：
2012-08-01
期刊：
影响因子：
3.9
通讯作者：
Barbounis, Vassilis
中科院分区：
文献类型：
--
作者：
Pavlakis, Kitty;Vrekoussis, Thomas;Barbounis, Vassilis
目的：确定在乳腺癌病例中定义Ki-67免疫组化表达百分比的观察者间变异程度，并研究使用14%的临界点进行Luminal B辅助治疗的有效性材料和方法：从“IASO”妇女医院病理档案中连续选取ER、PR阳性、Her 2阴性的乳腺癌99例。Ki-67免疫染色进行了评估，由四个病理学家从四个不同institutions.Results：关于整个研究组，观察员之间的协议是实质性的。对至少一名观察者评价Ki-67低于14%的病例进行的亚组分析表明，观察者间一致性降至一般。进一步的分析表明，低于和高于14%的临床病理学限制，代表一个“灰色地带”约+/-7%，其中观察者之间的协议是weak.Conclusion：在ER，PR阳性，Her 2阴性乳腺癌的Ki-67标记指数为14左右的细胞毒性治疗的管理，应谨慎考虑。也许决策还应该考虑到每个肿瘤的整个形态学和生物学特征。(c)2012爱思唯尔有限公司保留所有权利。
Aim: To determine the degree of inter-observer variability in defining the percentage of Ki-67 immunohistochemical expression in breast carcinoma cases and to investigate the validity of using the cut-point of 14% for the administration of adjuvant treatment in luminal B (Her2 negative) carcinomas.Materials and methods: 99 ER, PR positive, Her2 negative breast carcinomas were consecutively selected from the Pathology files of "IASO" Women's Hospital. Ki-67 immunostaining was evaluated by four pathologists from four different institutions.Results: Concerning the whole study group, the inter-observer agreement was substantial. Subgroup analysis upon the cases were at least one observer evaluated Ki-67 as being less than 14% showed that the inter-observer agreement was reduced to fair. Further analysis revealed that both below and above the clinicopathological limit of 14%, stands a "grey zone" of about +/- 7%, in which inter-observer agreement is weak.Conclusion: The administration of cytotoxic therapy in ER, PR positive, Her2 negative breast carcinomas featuring a Ki-67 labeling index of around 14, should be considered with caution. Probably decision-making should also take under consideration the whole morphological and biological profile of each tumor. (c) 2012 Elsevier Ltd. All rights reserved.