A simple index using video image analysis to predict disease outcome in primary breast cancer

Lockwood, Coralie A.; Ricciardelli, Carmela; Raymond, Wendy A.; Seshadri, Ram; McCaul, Kieran; Horsfall, Debbie

doi:10.1002/(sici)1097-0215(19990621)84:3<203::aid-ijc1>3.0.co;2-u

Cited by 26 publications

(13 citation statements)

References 27 publications

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“…We identified 47 cohort studies that assessed the role of Ki-67, as a prognostic factor solely (32 studies; 16,902 patient; patients received neoadjuvant treatment in one study, adjuvant treatment in 25 studies and no details of treatment were available in six studies), as a predictive factor solely (eight studies; 655 patients; patients received neoadjuvant treatment in six, adjuvant in one, and both in one study), or both as a prognostic and predictive factor (seven studies; 1,844 patients; all patients received neoadjuvant treatment) [2–4, 7–9, 14–19, 21–23, 30, 42–45, 49, 54–57, 59, 62, 63, 67, 73, 76, 78, 80–82, 84, 86–90, 92, 93, 96, 97, 104, 105]. We also identified one case–control study (828 patients) in which Ki-67 was assessed as a predictive factor for chemotherapy [1].…”

Section: Resultsmentioning

confidence: 99%

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Luporsi

André

Spyratos

et al. 2011

Breast Cancer Res Treat

263

189

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Clinicians can use biomarkers to guide therapeutic decisions in estrogen receptor positive (ER+) breast cancer. One such biomarker is cellular proliferation as evaluated by Ki-67. This biomarker has been extensively studied and is easily assayed by histopathologists but it is not currently accepted as a standard. This review focuses on its prognostic and predictive value, and on methodological considerations for its measurement and the cut-points used for treatment decision. Data describing study design, patients’ characteristics, methods used and results were extracted from papers published between January 1990 and July 2010. In addition, the studies were assessed using the REMARK tool. Ki-67 is an independent prognostic factor for disease-free survival (HR 1.05–1.72) in multivariate analyses studies using samples from randomized clinical trials with secondary central analysis of the biomarker. The level of evidence (LOE) was judged to be I-B with the recently revised definition of Simon. However, standardization of the techniques and scoring methods are needed for the integration of this biomarker in everyday practice. Ki-67 was not found to be predictive for long-term follow-up after chemotherapy. Nevertheless, high KI-67 was found to be associated with immediate pathological complete response in the neoadjuvant setting, with an LOE of II-B. The REMARK score improved over time (with a range of 6–13/20 vs. 10–18/20, before and after 2005, respectively). KI-67 could be considered as a prognostic biomarker for therapeutic decision. It is assessed with a simple assay that could be standardized. However, international guidelines are needed for routine clinical use.

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Section: Resultsmentioning

confidence: 99%

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Luporsi

André

Spyratos

et al. 2011

Breast Cancer Res Treat

263

189

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“…7 As it has been demonstrated that time to recurrence varies inversely with hormone receptor expression, 8 each patients' likelihood of benefiting from hormonal therapy depends significantly on the degree of ER and PR expression. [9][10][11][12][13][14][15] As tamoxifen has been associated with increased incidence of thromboembolic events and endometrial cancer, it is necessary to evaluate risk versus benefit for each patient. 16 …”

Section: Discussionmentioning

confidence: 99%

Semi-quantitative immunohistochemical assay versus oncotype DX® qRT-PCR assay for estrogen and progesterone receptors: an independent quality assurance study

et al. 2012

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Estrogen receptor (ER) status is a strong predictor of response to hormonal therapy in breast cancer patients. Presence of ER and level of expression have been shown to correlate with time to recurrence in patients undergoing therapy with tamoxifen or aromatase inhibitors. Risk reduction is also known to occur in ERnegative, progesterone receptor (PR)-positive patients treated with hormonal therapy. Since the 1990s, immunohistochemistry has been the primary method for assessing hormone receptor status. Recently, as a component of its oncotype DX s assay, Genomic Health began reporting quantitative estrogen and PR results determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR). As part of an ongoing quality assurance program at our institution, we reviewed 464 breast cancer cases evaluated by both immunohistochemistry and oncotype DX s assay for estrogen and PR. We found good correlation for ER status between both assays (98.9% concordance), with immunohistochemistry being slightly more sensitive. Concordance for PR was 94.2% between immunohistochemistry and qRT-PCR with immunohistochemistry again more sensitive than RT-PCR. The results also showed linear correlation between immunohistochemistry H-scores and qRT-PCR expression values for ER (correlation coefficient of 0.579), and PR (correlation coefficient of 0.685). Due to the higher sensitivity of hormone receptor immunohistochemistry and additional advantages (ie preservation of morphology, less expensive, faster, more convenient), we conclude immunohistochemistry is preferable to qRT-PCR for determination of estrogen and PR expression.

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“…16 20 The other group included a few tumour samples that contained numerous mitotic figures but lacked Ki-67 immunostaining, a surprising finding because Ki-67 staining commonly identifies G2/M phases. 20 Several 24 12 reasons have been advocated for the discrepancy; namely, a very low amount of Ki-67 antigen undetectable by the antibody used, or the occurrence of a mutated protein. 12 The alteration of protein expression in nutritionally deprived cells has also been suggested, 39 together with the inability of the Ki-67 antibody to identify S-phase arrested tumour cells.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15] We tested Ki-67, a nuclear antigen present in all active phases of the cell cycle (G1, S, G2, and mitosis (M)), 16 which is a valuable indicator of tumour proliferation and prognosis in patients with breast cancer. [17][18][19][20] The immunohistochemical Ki-67 index has the technical advantage, in relation to flow cytometry, of allowing the morphological evaluation of proliferating cell populations.…”

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confidence: 99%

Prognostic comparative study of S-phase fraction and Ki-67 index in breast carcinoma

Pinto¹,

André²,

Pereira³

et al. 2001

Journal of Clinical Pathology

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Aims-To investigate the prognostic value of recently proposed flow cytometric S-phase fraction (SPF) variables (average SPF and SPF tertiles) compared with conventional SPF, and to compare the one with the best predictive value with the immunohistochemical Ki-67 index in breast carcinoma. Methods-A short term follow up study (median, 39.6 months) of a large series of patients (n = 306) was conducted. DNA ploidy was analysed on fresh/frozen tumour samples by flow cytometry, and the SPF was calculated from the DNA histogram using an algorithm. The Ki-67 index was assessed on paraYn wax embedded material by immunohistochemistry (cut oV point, 10%). The two methods were compared by means of statistics, and the prognostic significance of both in relation to disease free survival (DFS) and overall survival (OS) was determined. Conclusions-Flow cytometric SPF is a better prognosticator than the Ki-67 index, but only SPF variables applied in the whole series show potential clinical usefulness. (J Clin Pathol 2001;54:543-549) Results-SPF

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A simple index using video image analysis to predict disease outcome in primary breast cancer

Cited by 26 publications

References 27 publications

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Semi-quantitative immunohistochemical assay versus oncotype DX® qRT-PCR assay for estrogen and progesterone receptors: an independent quality assurance study

Prognostic comparative study of S-phase fraction and Ki-67 index in breast carcinoma

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