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Calculation of the Ki67 index in pancreatic neuroendocrine tumors: a comparative analysis of four counting methodologies

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dc.contributor.authorERBARUT SEVEN, İPEK
dc.contributor.authorsReid, 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
dc.date.accessioned2022-03-14T11:07:43Z
dc.date.available2022-03-14T11:07:43Z
dc.date.issued2015-05
dc.description.abstractKi67 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.
dc.identifier.doi10.1038/modpathol.2014.156
dc.identifier.eissn1530-0285
dc.identifier.issn0893-3952
dc.identifier.pubmed25412850
dc.identifier.urihttps://hdl.handle.net/11424/245928
dc.identifier.wosWOS:000353774200008
dc.language.isoeng
dc.publisherNATURE PUBLISHING GROUP
dc.relation.ispartofMODERN PATHOLOGY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPROLIFERATIVE INDEX
dc.subjectLABELING INDEX
dc.subjectDIAGNOSIS
dc.subjectHETEROGENEITY
dc.subjectGUIDELINES
dc.subjectMANAGEMENT
dc.subjectTRACT
dc.titleCalculation of the Ki67 index in pancreatic neuroendocrine tumors: a comparative analysis of four counting methodologies
dc.typearticle
dspace.entity.typePublication
local.avesis.id5c960fae-aafc-4cfc-94d7-31a5e2f83c77
local.import.packageSS16
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages9
oaire.citation.endPage694
oaire.citation.issue5
oaire.citation.startPage686
oaire.citation.titleMODERN PATHOLOGY
oaire.citation.volume28
relation.isAuthorOfPublicationc4660df2-d1ab-47e7-b2aa-47ba7bad7a28
relation.isAuthorOfPublication.latestForDiscoveryc4660df2-d1ab-47e7-b2aa-47ba7bad7a28

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