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ERBARUT SEVEN, İPEK

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ERBARUT SEVEN

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İPEK

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2015 - 20202
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    PublicationOpen Access
    Calculation of the Ki67 index in pancreatic neuroendocrine tumors: a comparative analysis of four counting methodologies
    (NATURE PUBLISHING GROUP, 2015-05) ERBARUT SEVEN, İPEK; Reid, Michelle D.; Bagci, Pelin; Ohike, Nobuyuki; Saka, Burcu; Seven, Ipek Erbarut; Dursun, Nevra; Balci, Serdar; Gucer, Hasan; Jang, Kee-Taek; Tajiri, Takuma; Basturk, Olca; Kong, So Yeon; Goodman, Michael; Akkas, Gizem; Adsay, Volkan
    Ki67 index is now an essential part of classification of pancreatic neuroendocrine tumors. However, its adaptation into daily practice has been fraught with challenges related to counting methodology. In this study, three reviewers used four counting methodologies to calculate Ki67 index in 68 well-differentiated pancreatic neuroendocrine tumors: (1) 'eye-ball' estimation, which has been advocated as reliable and is widely used; (2) automated counting by image analyzer; (3) manual eye-counting (eye under a microscope without a grid); and (4) manual count of camera-captured/printed image. Pearson's correlation (R) was used to measure pair-wise correlation among three reviewers using all four methodologies. Average level of agreement was calculated using mean of R values. The results showed that: (1) 'eye-balling' was least expensive and fastest (average time <1 min) but had poor reliability and reproducibility. (2) Automated count was the most expensive and least practical with major impact on turnaround time (limited by machine and personnel accessibility), and, more importantly, had inaccuracies in overcounting unwanted material. (3) Manual eye count had no additional cost, averaged 6 min, but proved impractical and poorly reproducible. (4) Camera-captured/printed image was most reliable, had highest reproducibility, but took longer than 'eye-balling'. In conclusion, based on its comparatively low cost/benefit ratio and reproducibility, camera-captured/printed image appears to be the most practical for calculating Ki67 index. Although automated counting is generally advertised as the gold standard for index calculation, in this study it was not as accurate or cost-effective as camera-captured/printed image and was highly operator-dependent. 'Eye-balling' produces highly inaccurate and unreliable results, and is not recommended for routine use.
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    PublicationOpen Access
    The Contribution of Additional Sampling in Cholecystectomy Materials: A Multicenter Prospective Study
    (FEDERATION TURKISH PATHOLOGY SOC, 2020) ÇELİKEL, ÇİĞDEM; Abdullazade, Samir; Akarca, Fahire Goknur; Esendagli, Guldal; Turhan, Nesrin; Erden, Esra; Savas, Berna; Markoc, Fatma; Tuncel, Deniz; Yilmaz, Banu Ozguven; Saka, Burcu; Keser, Sevinc Hallac; Erhan, Selma Sengiz; Gucin, Zuhal; Sagol, Ozgul; Agalar, Anil Aysal; Celik, Sevinc; Ozer, Hatice; Erbarut Seven, Ipek; Celikel, Cigdem Ataizi; Ekinci, Ozgur; Egilmez, Hatice Reyhan; Balci, Serdar; Akyol, Gulen
    Objective: Cholecystectomy materials arc frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria. Material and Method: 14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined. Results: A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered. Conclusion: In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.