الفهرس 
Title : Evaluation of Ki-67 Index in Invasive Breast Cancer: Comparison between Visual and Automated Digital Assessment
AbstractOnly 14 pages are availabe for public view
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Abstract
Introduction: Breast cancer is by far the most frequent cancer among women. The proliferative index, Ki-67, is more and more taken into consideration for treatment decisions. However, the reliability of the established Ki-67 scoring is limited. Digital pathology is currently suggested to be a potential solution to Ki 67 assessment problems. Material and methods: A retrospective and prospective study including 100 patients diagnosed with invasive breast cancer. Three senior pathologists have been asked to estimate the Ki-67 proliferative index for each of the 100 cases by examining the whole glass slides by optical microscope and the virtual slides on the monitor and providing a continuous score then a categorical score {u2018}high{u2019} and {u2018}low{u2019} Ki 67 score using once 14% once 20% as threshold indicative of high ki67 status. Finally, a digital quantitative assessment of Ki67 was performed. Results: A high inter-observer agreement was found when using optical microscopy slides as well as virtual slides for Ki 67 assessment, with slightly higher Correlation coefficient (CC) values when using optical microscopy (0.717 to 0.882 versus 0.847 to 0.937). The overall agreement between the manual and automated evaluation of Ki 67 was only substantial (CC ranging from 0.696 and 0.791 on optical microscopy and 0.662 and 0.792 on computer screen (p value <0.01)). When using categorical scores, the inter-observers concordance was lower with virtual slides in comparison to optical microscopy with both cut off points. The inter-observers agreement of at least 2 pairs of observers was better while using 14% as cutoff point. Agreement between manual and automated assessment of Ki 67 indexes using both cutoff points was moderate to substantial