早期腔隙性乳腺癌的肿瘤增殖标志物分析:利用有丝分裂活动指数、Ki-67 和磷酸组蛋白 H3 表达的综合研究

IF 1 4区 医学 Q4 PATHOLOGY
P Jamshiya, Soundarya Ravi, Srinivas Bheemanathi Hanuman, Sree Rekha Jinkala, Ankit Jain, Prasanth Penumadu
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引用次数: 0

摘要

简介和目的:由于乳腺癌评估中观察者之间的差异很大,常规使用的增殖标记物(如有丝分裂活动指数(MAI)和 Ki-67 指数)的重现性有限。磷酸组蛋白 H3(PhH3)是一种新型的增殖标记物,在乳腺癌研究中日益受到关注。本研究旨在评估早期腔隙性乳腺癌中MAI、Ki-67和PhH3表达的评定者间一致性,并评估用PhH3指数替代MAI对肿瘤组织学分级的影响。材料与方法:三位病理学家对 66 例早期管腔型乳腺癌标本的 MAI、Ki-67 和 PhH3 表达进行评估。有丝分裂活性指数是根据 2 平方毫米面积上的有丝分裂数字来评分的,而 Ki-67 指数则采用 14% 的阳性染色核阈值。磷酸组蛋白 H3 表达临界值设定为每 2 平方毫米 13 个阳性细胞。使用 Cohen kappa 统计量分析了 3 个变量的评分者之间的一致性。结果显示在 3 个参数中,PhH3 表达的 kappa 评分反映出 3 位观察者之间的一致性非常高(κ = 0.991、0.907 和 0.916)。在 MAI 方面只有中等程度的一致性(κ = 0.898、0.562 和 0.592),而在 Ki-67 指数方面有很大的一致性(κ = 0.869、0.673 和 0.678)。此外,用 PhH3 指数取代 MAI 后,15% 至 16% 的患者的组织学分级得到提升。结论我们的研究表明,与 MAI 和 Ki-67 相比,PhH3 是一种可重复性更高的增殖标志物。在乳腺癌分级中纳入基于 PhH3 的有丝分裂指数可能会减少组织学分级评估中的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Tumor Proliferation Markers in Early-Stage Luminal Breast Cancer: A Comprehensive Study Using Mitotic Activity Index, Ki-67, and Phosphohistone H3 Expression.

Introduction and Aim: Routinely used proliferation markers such as mitotic activity index (MAI) and Ki-67 index show limited reproducibility due to high interobserver variability in breast cancer assessment. Phosphohistone H3 (PhH3), a novel proliferation marker, is gaining attention in breast cancer research. This study aimed to evaluate the inter-rater agreement among MAI, Ki-67, and PhH3 expressions in early-stage luminal breast cancer and assess the impact of replacing MAI with PhH3 index on tumor histological grading. Materials and Methods: Three pathologists assessed MAI, Ki-67, and PhH3 expressions in 66 early-stage luminal breast cancer specimens. Mitotic Activity Index was scored based on mitotic figures in an area of 2 mm2 while Ki-67 index utilized a 14% threshold for positively stained nuclei. Phosphohistone H3 expression cutoff was set at 13 positive cells per 2 mm2. The inter-rater agreement for the 3 variables was analyzed using Cohen kappa statistics. Results: Among the 3 parameters, the kappa score of the PhH3 expression reflected very strong agreement between the 3 observers (κ = 0.991, 0.907, and 0.916). Only moderate agreement was noted for MAI (κ = 0.898, 0.562, and 0.592) and substantial agreement for Ki-67 index (κ = 0.869, 0.673, and 0.678). Moreover, replacing MAI with PhH3 index led to upgrade of histological grade in 15% to 16% of patients. Conclusion: Our study demonstrated that PhH3 is a more reproducible proliferation marker than MAI and Ki-67. Incorporation of PhH3-based mitotic index in breast cancer grading might reduce the variation in the assessment of histological grade.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
198
审稿时长
1 months
期刊介绍: International Journal of Surgical Pathology (IJSP) is a peer-reviewed journal published eight times a year, which offers original research and observations covering all major organ systems, timely reviews of new techniques and procedures, discussions of controversies in surgical pathology, case reports, and images in pathology. This journal is a member of the Committee on Publication Ethics (COPE).
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