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Clinical usefulness of the free web-based image analysis application ImmunoRatio for assessment of Ki-67 labelling index in breast cancer
  1. Min-Kyung Yeo1,2,
  2. Hee Eun Kim1,
  3. Sung Hun Kim3,
  4. Byung Joo Chae4,
  5. Byung Joo Song4,
  6. Ahwon Lee1
  1. 1Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea
  2. 2Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
  3. 3Department of Radiology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
  4. 4Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
  1. Correspondence to Dr Ahwon Lee, Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea; klee{at}catholic.ac.kr

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.

  • BREAST CANCER
  • DIGITAL PATHOLOGY
  • 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-2016-204162

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    Footnotes

    • Handling editor Cheok Soon Lee

    • Contributors M-KY: analysed and interpreted data and wrote the paper. HEK: performed experiments. SHK: provided data. BJC: provided data. BJS: provided data. AL: designed the study, performed experiments and approved the final version of the paper.

    • Funding This study was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning (2014R1A1A3049554).

    • Competing interests None declared.

    • Ethics approval Institutional Review Board of Seoul St. Mary's Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.