ArticleVirchows Archiv : an international journal of pathology2013
Interobserver agreement of proliferation index (Ki-67) outperforms mitotic count in pulmonary carcinoids.
Article in Virchows Archiv : an international journal of pathology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The use of Ki-67 labeling index to grade pulmonary well-differentiated neuroendocrine neoplasms: current best evidence.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2018Pooled it
- Comparing non-machine learning vs. machine learning methods for Ki67 scoring in gastrointestinal neuroendocrine tumors.Scientific reports · 2025Article
- Neuroendocrine neoplasms of the lung: The latest updates.World journal of clinical oncology · 2025Review
- Article
- Lung carcinoid tumours: histology and Ki-67, the eternal rivalry.Histopathology · 2023Article
- Article
- Lung neuroendocrine neoplasms: recent progress and persistent challenges.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Review
- Automated Analysis of Proliferating Cells Spatial Organisation Predicts Prognosis in Lung Neuroendocrine Neoplasms.Cancers · 2021Article
- Prognostic nomogram for predicting long-term survival in bronchopulmonary carcinoid tumor patients receiving resection.Annals of translational medicine · 2021Article
- Multiple faces of pulmonary large cell neuroendocrine carcinoma: update with a focus on practical approach to diagnosis.Translational lung cancer research · 2020Review
- A Semiquantitative Scoring System May Allow Biopsy Diagnosis of Pulmonary Large Cell Neuroendocrine Carcinoma.American journal of clinical pathology · 2020Article
- Large cell neuroendocrine carcinoma with a solitary brain metastasis and low Ki-67: a unique subtype.Endocrine connections · 2019Article
- [Immunophenotyping of lung tumors : An update].Der Pathologe · 2019Review
- Automated quantification of Ki-67 index associates with pathologic grade of pulmonary neuroendocrine tumors.Chinese medical journal · 2019Article
- Distinctive pathological and clinical features of lung carcinoids with high proliferation index.Virchows Archiv : an international journal of pathology · 2017Article
- Lung neuroendocrine tumors: pathological characteristics.Journal of thoracic disease · 2017Review
- Classification of pulmonary neuroendocrine tumors: new insights.Translational lung cancer research · 2017Review
- Evaluation of diagnostic and prognostic significance of Ki-67 index in pulmonary carcinoid tumours.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2017Article
- Prognostic Significance of CD44 and Orthopedia Homeobox Protein (OTP) Expression in Pulmonary Carcinoid Tumours.Endocrine pathology · 2017Article
- Ki-67 labeling index of neuroendocrine tumors of the lung has a high level of correspondence between biopsy samples and surgical specimens when strict counting guidelines are applied.Virchows Archiv : an international journal of pathology · 2017Observational
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Evaluation of proliferative activity is a cornerstone in the classification of endocrine tumors; in pulmonary carcinoids, the mitotic count delineates typical carcinoid (TC) from atypical carcinoid (AC). Data on the reproducibility of manual mitotic counting and other methods of proliferation index evaluation in this tumor entity are sparse. Nine experienced pulmonary pathologists evaluated 20 carcinoid tumors for mitotic count (hematoxylin and eosin) and Ki-67 index. In addition, Ki-67 index was automatically evaluated with a software-based algorithm. Results were compared with respect to correlation coefficients (CC) and kappa values for clinically relevant grouping algorithms. Evaluation of mitotic activity resulted in a low interobserver agreement with a median CC of 0.196 and a median kappa of 0.213 for the delineation of TC from AC. The median CC for hotspot (0.658) and overall (0.746) Ki-67 evaluation was considerably higher. However, kappa values for grouped comparisons of overall Ki-67 were only fair (median 0.323). The agreement of manual and automated Ki-67 evaluation was good (median CC 0.851, median kappa 0.805) and was further increased when more than one participant evaluated a given case. Ki-67 staining clearly outperforms mitotic count with respect to interobserver agreement in pulmonary carcinoids, with the latter having an unacceptable low performance status. Manual evaluation of Ki-67 is reliable, and consistency further increases with more than one evaluator per case. Although the prognostic value needs further validation, Ki-67 might perspectively be considered a helpful diagnostic parameter to optimize the separation of TC from AC.
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