Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study

Introduction: The role of the Ki-67 Proliferative Index (PI) in the molecular classification and as a predictive and prognostic biomarker in breast cancer is definitive. To address the inconsistency in Ki-67 interpretation and scoring, the International Ki-67 in Breast Cancer Working Group (IKWG) in...

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Main Authors: Nidhi Radhakrishnan, Padma Priya Kasukurti, Sulata M Kamath, Clement Wilfred Devadass, SR Mangala Gouri
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2024-12-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/20356/74097_CE[Ra1]_F(SL)_QC(SD_IS)_PF1(AG_SS)_PFA(IS)_PB(AG_KM)_PN(KM).pdf
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author Nidhi Radhakrishnan
Padma Priya Kasukurti
Sulata M Kamath
Clement Wilfred Devadass
SR Mangala Gouri
author_facet Nidhi Radhakrishnan
Padma Priya Kasukurti
Sulata M Kamath
Clement Wilfred Devadass
SR Mangala Gouri
author_sort Nidhi Radhakrishnan
collection DOAJ
description Introduction: The role of the Ki-67 Proliferative Index (PI) in the molecular classification and as a predictive and prognostic biomarker in breast cancer is definitive. To address the inconsistency in Ki-67 interpretation and scoring, the International Ki-67 in Breast Cancer Working Group (IKWG) introduced the visual scoring Android Application (APP) and proposed a standardised scoring method. Aim: To determine Ki-67 proliferative indices by both the Global Method (GW) with the Ki-67 visual scoring app recommended by IKWG and conventional institutional Hotspot Method (HM), and to analyse the agreement between the indices obtained by these two methods. Materials and Methods: A cross-sectional study involving 71 Ki-67 immunostained hormone receptor-positive trucut biopsies of breast cancers from January 2022 to January 2024 were retrospectively collected. Two observers independently scored the biopsies using HM and GW by an app in the Department of Pathology of a tertiary care centre. The GW scores of Ki-67 PI obtained were categorised into low, intermediate and high groups based on 2015 St. Gallen guidelines. A two-way random Intraclass Correlation Coefficient (ICC) was used to assess the absolute agreement between two scorers. Results: The overall intraclass correlation between interobserver values by HM was 0.819 (good), while it was 0.971 (excellent) by GW. The overall interobserver mean difference was five times greater (p-value=0.008, statistically significant) than the overall interobserver global weighted scores (p-value=0.901, not statistically significant). Conclusion: The study highlighted the significant interobserver variability in HM compared to GW scores by the app. The standardised app scoring method has the potential to broaden the prognostic role of Ki-67 as a companion diagnostic tool.
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spelling doaj-art-aea4fd95846c4b3db526d033f5aec1962025-08-20T02:21:11ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2024-12-011812010410.7860/JCDR/2024/74097.20356Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional StudyNidhi Radhakrishnan0Padma Priya Kasukurti1Sulata M Kamath2Clement Wilfred Devadass3SR Mangala Gouri4Resident, Department of Pathology, Ramaiah Medical College, RUAS, Bengaluru, Karnataka, India.Assistant Professor, Department of Pathology, Ramaiah Medical College, RUAS, Bengaluru, Karnataka, IndiaProfessor, Department of Pathology, Ramaiah Medical College, RUAS, Bengaluru, Karnataka, India.Professor, Department of Pathology, Ramaiah Medical College, RUAS, Bengaluru, Karnataka, India.Professor, Department of Pathology, Ramaiah Medical College, RUAS, Bengaluru, Karnataka, India.Introduction: The role of the Ki-67 Proliferative Index (PI) in the molecular classification and as a predictive and prognostic biomarker in breast cancer is definitive. To address the inconsistency in Ki-67 interpretation and scoring, the International Ki-67 in Breast Cancer Working Group (IKWG) introduced the visual scoring Android Application (APP) and proposed a standardised scoring method. Aim: To determine Ki-67 proliferative indices by both the Global Method (GW) with the Ki-67 visual scoring app recommended by IKWG and conventional institutional Hotspot Method (HM), and to analyse the agreement between the indices obtained by these two methods. Materials and Methods: A cross-sectional study involving 71 Ki-67 immunostained hormone receptor-positive trucut biopsies of breast cancers from January 2022 to January 2024 were retrospectively collected. Two observers independently scored the biopsies using HM and GW by an app in the Department of Pathology of a tertiary care centre. The GW scores of Ki-67 PI obtained were categorised into low, intermediate and high groups based on 2015 St. Gallen guidelines. A two-way random Intraclass Correlation Coefficient (ICC) was used to assess the absolute agreement between two scorers. Results: The overall intraclass correlation between interobserver values by HM was 0.819 (good), while it was 0.971 (excellent) by GW. The overall interobserver mean difference was five times greater (p-value=0.008, statistically significant) than the overall interobserver global weighted scores (p-value=0.901, not statistically significant). Conclusion: The study highlighted the significant interobserver variability in HM compared to GW scores by the app. The standardised app scoring method has the potential to broaden the prognostic role of Ki-67 as a companion diagnostic tool.https://www.jcdr.net/articles/PDF/20356/74097_CE[Ra1]_F(SL)_QC(SD_IS)_PF1(AG_SS)_PFA(IS)_PB(AG_KM)_PN(KM).pdfbiomarker estimationbreast carcinomatumour proliferation
spellingShingle Nidhi Radhakrishnan
Padma Priya Kasukurti
Sulata M Kamath
Clement Wilfred Devadass
SR Mangala Gouri
Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
Journal of Clinical and Diagnostic Research
biomarker estimation
breast carcinoma
tumour proliferation
title Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
title_full Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
title_fullStr Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
title_full_unstemmed Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
title_short Agreement between Ki-67 Proliferative Index in Breast Cancer by Conventional Hotspot Method and International Ki-67 in Breast Cancer Working Group Global Scoring Method: A Cross-sectional Study
title_sort agreement between ki 67 proliferative index in breast cancer by conventional hotspot method and international ki 67 in breast cancer working group global scoring method a cross sectional study
topic biomarker estimation
breast carcinoma
tumour proliferation
url https://www.jcdr.net/articles/PDF/20356/74097_CE[Ra1]_F(SL)_QC(SD_IS)_PF1(AG_SS)_PFA(IS)_PB(AG_KM)_PN(KM).pdf
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AT clementwilfreddevadass agreementbetweenki67proliferativeindexinbreastcancerbyconventionalhotspotmethodandinternationalki67inbreastcancerworkinggroupglobalscoringmethodacrosssectionalstudy
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