ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
To score or not to score? Is Ki-67 analysis worthwhile in pituitary neuroendocrine tumours?
Paul Benjamin Loughrey 1,2 , Stephanie Craig 2 , Brian Herron 3 , Fatima Abdullahi Sidi 2 , Stephen McQuaid 2 , Paul Kelly 3 , Matt Humphries 2 , Eileen Parkes 4 , Darragh McArt 2 , Steven Hunter 1 , Marta Korbonits 5 & Jacqueline James 2
1Royal Victoria Hospital, Regional Centre for Endocrinology and Diabetes, Belfast, United Kingdom; 2Queen’s University, Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom; 3Royal Victoria Hospital, Cellular Pathology, Belfast, United Kingdom; 4University of Oxford, Medical Oncology, Oxford, United Kingdom; 5William Harvey Research Institute, Centre for Endocrinology, London, United Kingdom
Pituitary neuroendocrine tumours (PitNETs) are heterogeneous and have limited biomarkers to predict their behaviour, thus making their prognostication difficult. Ki-67 is a protein expressed in active phases of the cell cycle and is one of the biomarkers utilized in routine assessment of PitNET tissue. Current European Society of Endocrinology recommendations advise that histopathological analysis of PitNETs should as a minimum include Ki-67 proliferation index and anterior pituitary hormones. In addition, when Ki-67 index is ≥ 3%, p53 immunodetection and mitotic count should be undertaken. In order to obtain accurate Ki-67 assessment, manual counts of 1000 cells should be completed, which demands significant time and may be open to subjectivity. In addition, Ki-67 thresholds vary across studies and there has been debate about the proposed cut-off value of 3%. There are no internationally agreed guidelines for modern image analysis approaches in PitNETs. A retrospective assessment of Ki-67 index was piloted in 30 PitNETs of varying cell types using QuPath digital image analysis software. Digital cell counts of Ki67 index were undertaken in 1000 cells and 10,000 cells for comparative purposes. Average Ki-67 index per 10,000 cell count was 1.12% and per 1000 cell count it was 1.17%. Diagnostic reports of the 30 tumour samples identified three tumours with increased Ki-67 index. Digital image analysis of these three samples identified one of these as having a Ki-56 index ≥ 3%, while the other two had Ki-67 index < 3% on both 10,000 and 1000 cell counts. In addition, digital image analysis also identified a further sample with Ki-67 index ≥ 3% which was not originally reported as elevated. When appropriate detection thresholds are defined, QuPath digital analysis software identifies PitNET cells and Ki-67 positive cells. QuPath also facilitates assessment of Ki-67 in larger numbers of tumour cells which may provide a better representation of whole tumour Ki-67 expression. A further 200 tumour slides will be analyzed and presented alongside the 30 samples in this pilot study. In conclusion, this pilot study demonstrates QuPath is a reliable method to score Ki-67 index in PitNETs.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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