You are here

Article Text

Article menu

Download PDFPDF

Original article
The importance of tissue handling of surgically removed breast cancer for an accurate assessment of the Ki-67 index
  1. Nobuyuki Arima1,
  2. Reiki Nishimura2,
  3. Tomofumi Osako2,
  4. Yasuyuki Nishiyama2,
  5. Mamiko Fujisue2,
  6. Yasuhiro Okumura3,
  7. Masahiro Nakano3,
  8. Rumiko Tashima4,
  9. Yasuo Toyozumi5
  1. 1Department of Pathology, Kumamoto Shinto General Hospital, Kumamoto, Japan
  2. 2Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Japan
  3. 3Department of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan
  4. 4Department of Surgery, Kumamoto City Hospital, Kumamoto, Japan
  5. 5Department of Pathology, Kumamoto City Hospital, Kumamoto, Japan
  1. Correspondence to Dr Nobuyuki Arima, Department of Pathology, Kumamoto Shinto General Hospital, 1-17-27 Shinyashiki, Chuo-ku, Kumamoto 862-8655, Japan; nobuari0816{at}yahoo.co.jp

Abstract

Aim Insufficient attention for the Ki-67 immunohistochemistry has been given to the importance of tissue handling for surgical breast cancer specimens. We sought to investigate the effect of fixation status on the Ki-67.

Methods We examined the effect of fixative, time to and duration of fixation using surgical specimens, and finally, compared the paired Ki-67 index in the tumour between core needle and surgical specimen.

Results The Ki-67 was significantly higher when 10% neutral buffered formalin was used (p=0.0276). Insufficient fixation caused a drastic reduction in the Ki-67 index (p=0.0177), but not significant in oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). Sixteen hours delayed time to fixation also caused a reduction of the Ki-67 (p=0.0284), but not significant in ER. Prolonged fixation significantly led to a gradual reduction in the Ki-67 in a time-dependent manner, but not in both ER and HER2. Finally, cutting the tumour before fixation improved fixation status and consequently caused an increased level of the Ki-67 index (p=0.0181), which resulted in a strong correlation of the Ki-67 between core needle and surgical specimen (r=0.8595).

Conclusions Tissue handling of surgical specimen is critical for assessing the Ki-67 compared with ER and HER2. We should pay more attention to tissue fixation status for the standard assessment of the Ki-67 index.

  • TUMOUR BIOLOGY
  • IMMUNOHISTOCHEMISTRY
  • BREAST CANCER
  • PROLIFERATION

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/jclinpath-2015-203174

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text