ArticleBreast cancer research : BCR2016
Prognostic value of automated KI67 scoring in breast cancer: a centralised evaluation of 8088 patients from 10 study groups.
Article in Breast cancer research : BCR, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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47 citing papers in PubMed.
- Ki67 Is an Independent Predictor of Recurrence in the Largest Randomized Trial of 3 Radiation Fractionation Schedules in Localized Prostate Cancer.International journal of radiation oncology, biology, physics · 2018Trial
- Interrelation between lncRNA HOTAIR and EZH2 expression and progression free survival during endocrine treatment in breast cancer.BMC cancer · 2026Article
- Automated Assessment of Ki-67 Labeling Index Using Cell-Level Detection and Classification in Whole-Slide Images.Diagnostics (Basel, Switzerland) · 2026Article
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- Proliferative Markers in Breast Cancer and Chemotherapy Implications: A Comprehensive Review.Health science reports · 2025Article
- Conventional chemotherapy: millions of cures, unresolved therapeutic index.Nature reviews. Cancer · 2025Review
- Advancing Ki67 hotspot detection in breast cancer: a comparative analysis of automated digital image analysis algorithms.Histopathology · 2025Article
- The Ki67 dilemma: investigating prognostic cut-offs and reproducibility for automated Ki67 scoring in breast cancer.Breast cancer research and treatment · 2024Article
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- The Role of Ki-67 in HR+/HER2- Breast Cancer: A Real-World Study of 956 Patients.Breast cancer (Dove Medical Press) · 2024Article
- Use of a Novel Deep Learning Open-Source Model for Quantification of Ki-67 in Breast Cancer Patients in Pakistan: A Comparative Study between the Manual and Automated Methods.Diagnostics (Basel, Switzerland) · 2023Article
- SRSF3-Mediated Ki67 Exon 7-Inclusion Promotes Head and Neck Squamous Cell Carcinoma Progression via Repressing AKR1C2.International journal of molecular sciences · 2023Article
- Evaluation and comparison of different breast cancer prognosis scores based on gene expression data.Breast cancer research : BCR · 2023Article
- Ki67 assessment in invasive luminal breast cancer: a comparative study between different scoring methods.Histopathology · 2022Article
- Artificial intelligence-assisted interpretation of Ki-67 expression and repeatability in breast cancer.Diagnostic pathology · 2022Article
- Review
- A microfluidic cell-migration assay for the prediction of progression-free survival and recurrence time of patients with glioblastoma.Nature biomedical engineering · 2021Article
- Article
- A Diagnostic Analysis Workflow to Optimal Multiple Tumor Markers to Predict the Nonmetastatic Breast Cancer from Breast Lumps.Journal of oncology · 2021Article
- The Analysis of bcl-2 in Association with p53 and Ki-67 in Triple Negative Breast Cancer and Other Molecular Subtypes in Ghana.Journal of oncology · 2021Article
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Abstract
backgroundThe value of KI67 in breast cancer prognostication has been questioned due to concerns on the analytical validity of visual KI67 assessment and methodological limitations of published studies. Here, we investigate the prognostic value of automated KI67 scoring in a large, multicentre study, and compare this with pathologists' visual scores available in a subset of patients.
methodsWe utilised 143 tissue microarrays containing 15,313 tumour tissue cores from 8088 breast cancer patients in 10 collaborating studies. A total of 1401 deaths occurred during a median follow-up of 7.5 years. Centralised KI67 assessment was performed using an automated scoring protocol. The relationship of KI67 levels with 10-year breast cancer specific survival (BCSS) was investigated using Kaplan-Meier survival curves and Cox proportional hazard regression models adjusted for known prognostic factors.
resultsPatients in the highest quartile of KI67 (>12 % positive KI67 cells) had a worse 10-year BCSS than patients in the lower three quartiles. This association was statistically significant for ER-positive patients (hazard ratio (HR) (95 % CI) at baseline = 1.96 (1.31-2.93); P = 0.001) but not for ER-negative patients (1.23 (0.86-1.77); P = 0.248) (P-heterogeneity = 0.064). In spite of differences in characteristics of the study populations, the estimates of HR were consistent across all studies (P-heterogeneity = 0.941 for ER-positive and P-heterogeneity = 0.866 for ER-negative). Among ER-positive cancers, KI67 was associated with worse prognosis in both node-negative (2.47 (1.16-5.27)) and node-positive (1.74 (1.05-2.86)) tumours (P-heterogeneity = 0.671). Further classification according to ER, PR and HER2 showed statistically significant associations with prognosis among hormone receptor-positive patients regardless of HER2 status (P-heterogeneity = 0.270) and among triple-negative patients (1.70 (1.02-2.84)). Model fit parameters were similar for visual and automated measures of KI67 in a subset of 2440 patients with information from both sources.
conclusionsFindings from this large-scale multicentre analysis with centrally generated automated KI67 scores show strong evidence in support of a prognostic value for automated KI67 scoring in breast cancer. Given the advantages of automated scoring in terms of its potential for standardisation, reproducibility and throughput, automated methods appear to be promising alternatives to visual scoring for KI67 assessment.
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