Comparison of digital image analysis and visual scoring of KI-67 in prostate cancer prognosis after prostatectomy

Diagnostic Pathology

Vincent Fradet⁴  Bernard Têtu¹  Yves Fradet³  Louis Lacombe³  André Caron²  Caroline Léger³  Molière Nguilé-Makao³  Hélène Hovington³  Patrice Desmeules¹ 

[1] Anatomic Pathology and Cytology Department, Hôpital du St-Sacrement, Centre Hospitalier Universitaire (CHU) de Québec, Laval University, Québec, Canada;Population Health Unit (URESP), Centre de recherche FRQS du Centre hospitalier affilié universitaire de Québec, Québec, Canada;Cancer Research Centre, CHU de Québec, Québec, Canada;Centre de recherche en cancérologie de l’Université Laval, Centre Hospitalier Universitaire de Québec – pavillon L’Hôtel-Dieu de Québec, 10 rue McMahon, Québec G1R3S1, QC, Canada

关键词: Digital image analysis;    Mortality;    Biochemical recurrence;    Proliferation;    Prostate cancer;   

Others  :  1219380
DOI  :  10.1186/s13000-015-0294-0

 received in 2014-12-15, accepted in 2015-05-05,  发布年份 2015

【 摘 要 】

Background

The tumor proliferative index marker Ki-67 was shown to be associated with clinically significant outcomes in prostate cancer, but its clinical application has limitations due to lack of uniformity and consistency in quantification. Our objective was to compare the measurements obtained with digital image analysis (DIA) versus virtual microscopy (visual scoring (VS)).

Methods

To do so, we compared the measurement distributions of each technique and their ability to predict clinically useful endpoints. A tissue microarray series from a cohort of 225 men who underwent radical prostatectomy was immunostained for Ki-67. The percentage of Ki-67 positive nuclei in malignant cells was assessed both by VS and DIA, and a H–score was calculated. The distribution and predictive ability of these scoring methods to predict biochemical recurrence (BCR) and death from prostate cancer (DPCa) were compared using Mann–Whitney test and C-index.

Results

The measurements obtained with VS were similar to the DIA measurements (p = 0.73) but dissimilar to the H-score (p < 0.001). Cox regression models showed that Ki-67 was associated with BCR (HR 1.46, 95 % CI 1.10-1.94) and DPCa (HR 1.26, 95 % CI 1.06-1.50). C-indexes revealed that Ki-67 was a better predictor of DPCa (0.803, 0.8059 and 0.789; VS, DIA and H-score, respectively) than of BCR (0.625, 0.632 and 0.604; VS, DIA and H-score, respectively).

Conclusion

The measurement distributions and the predictive abilities of VS and DIA were similar and presented the same predictive behaviour in our cohort, supporting the role of Ki-67 proliferative index as an important prognostic factor of BCR and DPCa in prostate cancer post RP.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6656878501536663 webcite

【 授权许可】

   
2015 Desmeules et al.

【 图 表 】

Fig. 1.

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Fig. 3.

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