TITLE:
Assessment and Visualization of Ki67 Heterogeneity in Breast Cancers through Digital Image Analysis
AUTHORS:
Chien-Hui Wu, Min-Hsiang Chang, Hsin-Hsiu Tsai, Yi-Ting Peng
KEYWORDS:
Ki67 Heterogeneity, Breast Cancer, Digital Image Analysis
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.13 No.2,
April
15,
2024
ABSTRACT: The Ki67 index (KI) is a standard clinical marker for tumor proliferation; however, its application is hindered by intratumoral heterogeneity. In this study, we used digital image analysis to comprehensively analyze Ki67 heterogeneity and distribution patterns in breast carcinoma. Using Smart Pathology software, we digitized and analyzed 42 excised breast carcinoma Ki67 slides. Boxplots, histograms, and heat maps were generated to illustrate the KI distribution. We found that 30% of cases (13/42) exhibited discrepancies between global and hotspot KI when using a 14% KI threshold for classification. Patients with higher global or hotspot KI values displayed greater heterogenicity. Ki67 distribution patterns were categorized as randomly distributed (52%, 22/42), peripheral (43%, 18/42), and centered (5%, 2/42). Our sampling simulator indicated analyzing more than 10 high-power fields was typically required to accurately estimate global KI, with sampling size being correlated with heterogeneity. In conclusion, using digital image analysis in whole-slide images allows for comprehensive Ki67 profile assessment, shedding light on heterogeneity and distribution patterns. This spatial information can facilitate KI surveys of breast cancer and other malignancies.