Grading invasive ductal carcinoma of the breast: advantages of using automated proliferation index instead of mitotic count

被引:23
作者
Tawfik, Ossama
Kimler, Bruce F.
Davis, Marilyn
Stasik, Christopher
Lai, Sue-Min
Mayo, Matthew S.
Fan, Fang
Donahue, John K.
Damjanov, Ivan
Thomas, Patricia
Connor, Carol
Jewell, William R.
Smith, Holly
Fabian, Carol J.
机构
[1] Univ Kansas, Med Ctr, Dept Pathol & Lab Med, Kansas City, KS 66160 USA
[2] Univ Kansas, Med Ctr, Dept Radiat Oncol, Kansas City, KS 66160 USA
[3] Univ Kansas, Med Ctr, Dept Prevent Med & Publ Hlth, Kansas City, KS 66160 USA
[4] Univ Kansas, Med Ctr, Dept Surg, Kansas City, KS 66160 USA
[5] Univ Kansas, Med Ctr, Ctr Biostat & Adv Informat, Kansas City, KS 66160 USA
[6] Univ Kansas, Med Ctr, Dept Med, Div Oncol, Kansas City, KS 66160 USA
关键词
invasive breast carcinoma grading; MIB-1 (Ki-67) Immunohistochemistry; automation; image analysis; survival; PATHOLOGICAL PROGNOSTIC FACTORS; CELL NUCLEAR ANTIGEN; S-PHASE FRACTION; TERM FOLLOW-UP; INTEROBSERVER REPRODUCIBILITY; MONOCLONAL-ANTIBODY; LABELING INDEX; FIGURE COUNT; CANCER; KI-67;
D O I
10.1007/s00428-007-0400-0
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Breast carcinomas are graded according to the "Nottingham modification of the Bloom-Richardson system" (SBR). The system is hindered, however, by lack of precision in assessing all three parameters including nuclear grade, mitosis, and tubular formation, leading to an element of subjectivity. Our objective was to evaluate a new grading system [the nuclear grade plus proliferation (N+P) system] for subjectivity, ease, and better representation of tumor biology. Its components are nuclear grade and automated proliferation index. Invasive ductal carcinomas, consisting of 137 SBR grade I, 247 grade II, and 266 grade III, were re-evaluated by the N+P system. The two systems were compared with each other and correlated with patients' overall survival, tumor size, angiolymphatic invasion, lymph node status, and biomarker status including estrogen receptor, progesterone receptor, p53, epidermal growth factor receptor, BCL-2, and Her-2. Although there was an agreement between the two systems with histologic and prognostic parameters studied, there was 37% disagreement when grading individual tumors. Fifty-three percent of SBR grade II tumors were "down-graded" to N+P grade I, and 7% were "up-graded" to N+P grade III. Distinction among the different histologic grades for overall survival curves was better indicated by the N+P than the SBR system.
引用
收藏
页码:627 / 636
页数:10
相关论文
共 60 条
  • [1] Invasive lobular carcinoma: to grade or not to grade
    Bane, AL
    Tjan, S
    Parkes, RK
    Andrulis, I
    O'Malley, FP
    [J]. MODERN PATHOLOGY, 2005, 18 (05) : 621 - 628
  • [2] PROGNOSIS IN BREAST-CANCER UTILIZING HISTOLOGIC CHARACTERISTICS OF PRIMARY TUMOR
    BLACK, MM
    BARCLAY, THC
    HANKEY, BF
    [J]. CANCER, 1975, 36 (06) : 2048 - 2055
  • [3] HISTOLOGICAL GRADING AND PROGNOSIS IN BREAST CANCER - A STUDY OF 1409 CASES OF WHICH 359 HAVE BEEN FOLLOWED FOR 15 YEARS
    BLOOM, HJG
    RICHARDSON, WW
    [J]. BRITISH JOURNAL OF CANCER, 1957, 11 (03) : 359 - &
  • [4] Boiesen P, 2000, ACTA ONCOL, V39, P41
  • [5] Brown RW, 1996, CLIN CANCER RES, V2, P585
  • [6] Cady B, 1996, ARCH SURG-CHICAGO, V131, P301
  • [7] MONOCLONAL-ANTIBODIES AGAINST RECOMBINANT PARTS OF THE KI-67 ANTIGEN (MIB-1 AND MIB-3) DETECT PROLIFERATING CELLS IN MICROWAVE-PROCESSED FORMALIN-FIXED PARAFFIN SECTIONS
    CATTORETTI, G
    BECKER, MHG
    KEY, G
    DUCHROW, M
    SCHLUTER, C
    GALLE, J
    GERDES, J
    [J]. JOURNAL OF PATHOLOGY, 1992, 168 (04) : 357 - 363
  • [8] Ten-year outcomes in a population-based cohort of node-negative, lymphatic, and vascular invasion-negative early breast cancers without adjuvant systemic therapies
    Chia, SK
    Speers, CH
    Bryce, CJ
    Hayes, MM
    Olivotto, IA
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (09) : 1630 - 1637
  • [9] The utility of mitotic index, oestrogen receptor and Ki-67 measurements in the creation of novel prognostic indices for node-negative breast cancer
    Clahsen, PC
    van de Velde, CJH
    Duval, C
    Pallud, C
    Mandard, AM
    Delobelle-Deroide, A
    van den Broek, L
    van de Vijver, MJ
    [J]. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY, 1999, 25 (04): : 356 - 363
  • [10] DALTON LW, 1994, CANCER, V73, P2765, DOI 10.1002/1097-0142(19940601)73:11<2765::AID-CNCR2820731119>3.0.CO