Arima Nobuyuki, Nishimura Reiki, Osako Tomofumi, Nishiyama Yasuyuki, Fujisue Mamiko, Okumura Yasuhiro, Nakano Masahiro, Tashima Rumiko, Toyozumi Yasuo
Department of Pathology, Kumamoto Shinto General Hospital, Kumamoto, Japan.
Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Japan.
J Clin Pathol. 2016 Mar;69(3):255-9. doi: 10.1136/jclinpath-2015-203174. Epub 2015 Sep 29.
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.
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.
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).
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.
对于乳腺癌手术标本的组织处理对Ki-67免疫组化的重要性，人们关注不足。我们试图研究固定状态对Ki-67的影响。
我们使用手术标本研究了固定剂、固定时间和固定持续时间的影响，最后比较了粗针穿刺活检标本与手术标本中肿瘤的配对Ki-67指数。
使用10%中性缓冲福尔马林时，Ki-67显著更高（p = 0.0276）。固定不足导致Ki-67指数急剧下降（p = 0.0177），但对雌激素受体（ER）和人表皮生长因子受体2（HER2）无显著影响。固定延迟16小时也导致Ki-67降低（p = 0.0284），但对ER无显著影响。长时间固定显著导致Ki-67以时间依赖性方式逐渐降低，但对ER和HER2均无此影响。最后，在固定前切割肿瘤改善了固定状态，从而导致Ki-67指数水平升高（p = 0.0181），这使得粗针穿刺活检标本与手术标本之间的Ki-67具有很强的相关性（r = 0.8595）。
与ER和HER2相比，手术标本的组织处理对于评估Ki-67至关重要。我们应该更加关注组织固定状态，以便对Ki-67指数进行标准化评估。
