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. 2017 Aug;70(8):715-719.
doi: 10.1136/jclinpath-2016-204162. Epub 2017 Mar 15.

Clinical usefulness of the free web-based image analysis application ImmunoRatio for assessment of Ki-67 labelling index in breast cancer

Min-Kyung Yeo  1   2 , Hee Eun Kim  1 , Sung Hun Kim  3 , Byung Joo Chae  4 , Byung Joo Song  4 , Ahwon Lee  1
Affiliations

Clinical usefulness of the free web-based image analysis application ImmunoRatio for assessment of Ki-67 labelling index in breast cancer

Min-Kyung Yeo et al. J Clin Pathol. 2017 Aug.

Abstract

Aims: Ki-67 is a prognostic marker in breast cancer; however, the use of the Ki-67 labelling index (LI) in clinical practice requires a consistent and easily accessible scoring method. The present study evaluated the use of the free internet-based image analysis program ImmunoRatio to score Ki-67 LI in breast cancer in comparison with manual counting.

Methods: Ki-67 immunohistochemical detection was performed in 577 breast cancer cases, and the Ki-67 LI was determined by ImmunoRatio and manual counting.

Results: The Ki-67 LI determined by ImmunoRatio correlated well with that obtained by manual counting. The concordance rate between ImmunoRatio and manual counting was excellent (κ coefficient of 0.881) at a Ki-67 LI cut-off value of 20%. Cases with high Ki-67 LI by ImmunoRatio were associated with poor overall survival, in particular in the hormone receptor positive group.

Conclusions: The web-based automated image analysis program ImmunoRatio is an attractive alternative to manual counting to determine the Ki-67 LI in breast cancer.

Keywords: BREAST CANCER; DIGITAL PATHOLOGY; PROLIFERATION.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Ki-67 immunohistochemically stained slides were scanned and edited to remove stromal tissue from the tumour nest before the use of ImmunoRatio (A→B, C→D).
Figure 2
Figure 2
Uploaded Ki-67 images were convoluted to ImmunoRatio pseudocoloured (montage) images (A→B, C→D and E→F). ImmunoRatio recognised diaminobenzidine (DAB) and haematoxylin staining separately and scored the Ki-67 labelling index (LI).
Figure 3
Figure 3
Excellent correlation between the Ki-67 labelling index (LI) using ImmunoRatio and manual counting.
Figure 4
Figure 4
Kaplan-Meier overall survival curves based on the Ki-67 labelling index (LI) using ImmunoRatio (A) and manual counting (B) using a 20% cut-off value in a total of 577 breast cancer cases.
Figure 5
Figure 5
In the hormone receptor positive group, Kaplan-Meier curves show a relationship between poor overall survival and high Ki-67 labelling index (LI) (20% cut-off) using ImmunoRatio (A) and manual counting (B).
See this image and copyright information in PMC

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