Difference between revisions of "Template:Immunohistochemistry evaluation of invasive breast cancer"
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====Ki-67 index==== | ====Ki-67 index==== | ||
[[File:Positive immunohistochemistry of KI-67 in invasive breast cancer.jpg|thumb|Ki-67 in an invasive breast cancer: cancer nuclei are stained (brown). There is tumor cell positivity in 70% of the cells (''Ki-67 labelling index'' = 70%).]] | [[File:Positive immunohistochemistry of KI-67 in invasive breast cancer.jpg|thumb|Ki-67 in an invasive breast cancer: cancer nuclei are stained (brown). There is tumor cell positivity in 70% of the cells (''Ki-67 labelling index'' = 70%).]] | ||
| − | + | Ki-67 index is mainly relevant in those with stage T1-T2, N0-N1, to determine if chemotherapy is needed (if Ki67 is >30% rather than <5%).<ref name="DowsettNielsen2011">{{cite journal|last1=Dowsett|first1=M.|last2=Nielsen|first2=T. O.|last3=A'Hern|first3=R.|last4=Bartlett|first4=J.|last5=Coombes|first5=R. C.|last6=Cuzick|first6=J.|last7=Ellis|first7=M.|last8=Henry|first8=N. L.|last9=Hugh|first9=J. C.|last10=Lively|first10=T.|last11=McShane|first11=L.|last12=Paik|first12=S.|last13=Penault-Llorca|first13=F.|last14=Prudkin|first14=L.|last15=Regan|first15=M.|last16=Salter|first16=J.|last17=Sotiriou|first17=C.|last18=Smith|first18=I. E.|last19=Viale|first19=G.|last20=Zujewski|first20=J. A.|last21=Hayes|first21=D. F.|title=Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group|journal=JNCI Journal of the National Cancer Institute|volume=103|issue=22|year=2011|pages=1656–1664|issn=0027-8874|doi=10.1093/jnci/djr393}}</ref> | |
| − | + | Ki-67 index is most feasibly quantified by a hot spot method,<ref group=notes>Besides from a hot spot method of Ki67 counting, there is also a ''IKWG global average'' method which is more comprehensive. However, the inter-observer difference between the hot spot method and the 'IKWG global average'' is not statistically significant,<ref name="DowsettNielsen2011"/> and has not shown any significant difference in clinical outcome (theoretically, the area of highest Ki-67 proliferative index is probably most likely to correlate with malignant transformation and risk of metastasis, making the hot spot both more straightforward and clinically relevant than a global average).<br>'''Reference and instructions for the ''IKWG global average'' method:''' {{cite journal|last1=Dowsett|first1=M.|last2=Nielsen|first2=T. O.|last3=A'Hern|first3=R.|last4=Bartlett|first4=J.|last5=Coombes|first5=R. C.|last6=Cuzick|first6=J.|last7=Ellis|first7=M.|last8=Henry|first8=N. L.|last9=Hugh|first9=J. C.|last10=Lively|first10=T.|last11=McShane|first11=L.|last12=Paik|first12=S.|last13=Penault-Llorca|first13=F.|last14=Prudkin|first14=L.|last15=Regan|first15=M.|last16=Salter|first16=J.|last17=Sotiriou|first17=C.|last18=Smith|first18=I. E.|last19=Viale|first19=G.|last20=Zujewski|first20=J. A.|last21=Hayes|first21=D. F.|title=Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group|journal=JNCI Journal of the National Cancer Institute|volume=103|issue=22|year=2011|pages=1656–1664|issn=0027-8874|doi=10.1093/jnci/djr393}}</ref> Hot spots are areas in which Ki-67 staining is particularly higher relative to the adjacent tumor areas.<ref name="ColemanJang2017">{{cite journal|last1=Coleman|first1=William B.|last2=Jang|first2=Min Hye|last3=Kim|first3=Hyun Jung|last4=Chung|first4=Yul Ri|last5=Lee|first5=Yangkyu|last6=Park|first6=So Yeon|title=A comparison of Ki-67 counting methods in luminal Breast Cancer: The Average Method vs. the Hot Spot Method|journal=PLOS ONE|volume=12|issue=2|year=2017|pages=e0172031|issn=1932-6203|doi=10.1371/journal.pone.0172031}}</ref> Usually, the invasive edge of a tumor is a hot spot.<ref name="ColemanJang2017"/> When a tumor had several hot spots, the “hottest” spot is selected.<ref name="ColemanJang2017"/> Aim to count at least 500 cells in each case, but this is not always possible in cases with low tumor cell density and small tumor size.<ref name="ColemanJang2017"/> Also aim to include at least three high-power (×40 objective) fields. <ref>{{cite web|url=https://www.ki67inbreastcancerwg.org/wp-content/uploads/2018/12/Ki67-Phase-3b-WS-protocol-v1.pdf|title=Ki67-QC international working group: whole section scoring protocol (global method)|date=2018-11-29|website=International Ki67 in Breast Cancer Working Group}}</ref> If a comparisons must be made between core biopsies and sections from an excision, evaluation of the latter should be across the whole tumor.<ref name="DowsettNielsen2011"/> Only nuclear staining counts. Staining intensity of a positive nucleus is not relevant.<ref name="DowsettNielsen2011"/> | |
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====HER2/neu ==== | ====HER2/neu ==== | ||
Revision as of 13:09, 19 September 2021
Contents
Immunohistochemistry
Ki-67 index
Ki-67 index is mainly relevant in those with stage T1-T2, N0-N1, to determine if chemotherapy is needed (if Ki67 is >30% rather than <5%).[1]
Ki-67 index is most feasibly quantified by a hot spot method,Cite error: Closing </ref> missing for <ref> tag Hot spots are areas in which Ki-67 staining is particularly higher relative to the adjacent tumor areas.[2] Usually, the invasive edge of a tumor is a hot spot.[2] When a tumor had several hot spots, the “hottest” spot is selected.[2] Aim to count at least 500 cells in each case, but this is not always possible in cases with low tumor cell density and small tumor size.[2] Also aim to include at least three high-power (×40 objective) fields. [3] If a comparisons must be made between core biopsies and sections from an excision, evaluation of the latter should be across the whole tumor.[1] Only nuclear staining counts. Staining intensity of a positive nucleus is not relevant.[1]
HER2/neu
| Score[4] | Status[4] |
|---|---|
| 0 to 1+ | HER2 negative (not present) |
| 2+ | Borderline |
| 3+ | HER2 positive |
HER2/neu staining is seen as a cell membrane with continuous brown color.
Notes
Main page
References
- ↑ 1.0 1.1 1.2 Dowsett, M.; Nielsen, T. O.; A'Hern, R.; Bartlett, J.; Coombes, R. C.; Cuzick, J.; Ellis, M.; Henry, N. L.; et al. (2011). "Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group ". JNCI Journal of the National Cancer Institute 103 (22): 1656–1664. doi:. ISSN 0027-8874.
- ↑ 2.0 2.1 2.2 2.3 Coleman, William B.; Jang, Min Hye; Kim, Hyun Jung; Chung, Yul Ri; Lee, Yangkyu; Park, So Yeon (2017). "A comparison of Ki-67 counting methods in luminal Breast Cancer: The Average Method vs. the Hot Spot Method ". PLOS ONE 12 (2): e0172031. doi:. ISSN 1932-6203.
- ↑ . Ki67-QC international working group: whole section scoring protocol (global method). International Ki67 in Breast Cancer Working Group (2018-11-29).
- ↑ 4.0 4.1 . IHC Tests (ImmunoHistoChemistry). Breastcancer.org. Retrieved on 2019-10-04. Last modified on October 23, 2015
Image sources
