Hasegawa Tadashi, Yamamoto Seiichiro, Matsuno Yoshihiro
Division of Pathology, National Cancer Center Research Institute and Hospital, Tokyo, Japan.
Pathol Int. 2002 Jul;52(7):433-7. doi: 10.1046/j.1440-1827.2002.01378.x.
We have found that the MIB-1 grade, based on tumor differentiation/histological type, necrosis and Ki-67 (MIB-1) score, is a valid and reproducible prognostic system for adult soft-tissue sarcomas. However, there are limited data available on Ki-67 labeling indices (LI) from adult soft-tissue sarcomas for testing the validity of quantitative image analysis. In this study, the records of 146 adult patients with soft-tissue sarcomas of the extremities and trunk were retrieved, and MIB-1 immunostaining was carried out for the grading. The counted MIB-1 LI values and the scores estimated from microscopic observation were defined as the gold standard. The correlation between MIB-1 LI as assessed by computer-assisted image analysis and by microscopic observation was determined. The image analysis -based MIB-1 LI was highly correlated with the microscopic observation-based MIB-1 LI (r = 0.87, 95% confidence interval (CI) = 0.82-0.92). In addition, agreement between the MIB-1 scores was very high (kappa statistic = 0.83, 95% CI = 0.75-0.91), as was the percentage agreement (89%, 95% CI = 82.8-93.6%) between the results from image analysis and microscopic observation. We conclude that quantitative immunohistochemical evaluation of MIB-1 LI by image analysis enables pathologists to improve interobserver agreement in the assessment of MIB-1 score, and can help to objectively assign the correct histological grade to cases of adult soft-tissue sarcoma, resulting in optimal clinical management.
我们发现，基于肿瘤分化/组织学类型、坏死情况和Ki-67（MIB-1）评分的MIB-1分级系统，对于成人软组织肉瘤是一种有效且可重复的预后系统。然而，关于成人软组织肉瘤的Ki-67标记指数（LI），用于测试定量图像分析有效性的数据有限。在本研究中，检索了146例成人四肢和躯干软组织肉瘤患者的记录，并进行MIB-1免疫染色以进行分级。将计数的MIB-1 LI值和通过显微镜观察估计的评分定义为金标准。确定了计算机辅助图像分析评估的MIB-1 LI与显微镜观察评估的MIB-1 LI之间的相关性。基于图像分析的MIB-1 LI与基于显微镜观察的MIB-1 LI高度相关（r = 0.87，95%置信区间（CI）= 0.82 - 0.92）。此外，MIB-1评分之间的一致性非常高（kappa统计量 = 0.83，95% CI = 0.75 - 0.91），图像分析和显微镜观察结果之间的百分比一致性也很高（89%，95% CI = 82.8 - 93.6%）。我们得出结论，通过图像分析对MIB-1 LI进行定量免疫组化评估，能够使病理学家在评估MIB-1评分时提高观察者间的一致性，并有助于客观地为成人软组织肉瘤病例确定正确的组织学分级，从而实现最佳的临床管理。
