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Diagnostic Pathology
Published in: Diagnostic Pathology 1/2018

Open Access 01-12-2018 | Research

Evaluation of the proliferation marker Ki-67 in gliomas: Interobserver variability and digital quantification

Authors: Ljudmilla A. G. Nielsen, Julie A. Bangsø, Kim H. Lindahl, Rikke H. Dahlrot, Jacob v. B. Hjelmborg, Steinbjørn Hansen, Bjarne W. Kristensen

Published in: Diagnostic Pathology | Issue 1/2018

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Abstract

Background

The Ki-67 Labelling Index (LI) is used as an ancillary tool in glioma diagnostics. Interobserver variability has been reported and no precise guidelines are available. Nor is it known whether novel digital approaches would be an advantage. Our aim was to evaluate the inter- and intraobserver variability of the Ki-67 LI between two pathologists and between pathologists and digital quantification both in whole tumour slides and in hot spots using narrow but diagnostically relevant intervals.

Methods

In samples of 235 low and high grade gliomas, two pathologists (A and B) estimated the Ki-67 LI (5–10% intervals) for whole tumour slides and for hot spots. In 20 of the cases intraobserver variability was evaluated. For digital quantification (C) slides were scanned with subsequent systematic random sampling of viable tumour areas. A software classifier trained to identify positive and negative nuclei calculated the Ki-67 LI. The interobserver agreements were evaluated using kappa (κ) statistics.

Results

The observed proportions of agreement and κ values for Ki-67 LI for whole tumour slides were: A/B: 46% (κ = 0.32); A/C: 37% (κ = 0.26); B/C: 37% (κ = 0.26). For hot spots equivalent values were: A/B: 14% (κ = 0.04); A/C: 18% (κ = 0.09); B/C: 31% (κ = 0.21).

Conclusions

Interobserver variability was pronounced between pathologists and for pathologists versus digital quantification when attempting to estimate a precise value of the Ki-67 LI. Ki-67 LI should therefore be used with caution and should not be over interpreted in the grading of gliomas. Digital quantification of Ki-67 LI in gliomas was feasible, but intra- and interlaboratory robustness need to be determined.
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Metadata
Title
Evaluation of the proliferation marker Ki-67 in gliomas: Interobserver variability and digital quantification
Authors
Ljudmilla A. G. Nielsen
Julie A. Bangsø
Kim H. Lindahl
Rikke H. Dahlrot
Jacob v. B. Hjelmborg
Steinbjørn Hansen
Bjarne W. Kristensen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2018
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/s13000-018-0711-2

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