title: Software-automated counting of Ki-67 proliferation index correlates with pathologic grade and disease progression of follicular lymphomas.
abstract: OBJECTIVE
  To examine the accuracy of software-assisted measurement of the Ki-67 proliferation index (PI) and its correlation with the grade and clinical progression of follicular lymphoma (FL).
  
  
  METHODS
  High-power field equivalents were extracted from H&E- and Ki-67-immunostained slides of FL, and a nuclear quantitation algorithm was used to calculate a PI. Representative fields were manually counted for validation with close agreement.
  
  
  RESULTS
  The PI was significantly higher in World Health Organization grade 3 FL than grade 1 to 2 FL. Disease progression, as defined by subsequent treatment with radiation or cytotoxic chemotherapy, was also significantly associated with elevated PI but not pathologic grade.
  
  
  CONCLUSIONS
  These data show that software-automated quantitation of Ki-67 can provide both a useful adjunct to pathologic grade in FL and improved prognostic information for patients.
authors.affiliation: Dept of Pathology, The Johns Hopkins Medical Institutions, Weinberg 2242 Pathology, 401 N Broadway, Baltimore, MD 21231-2410; aduffie1@jhmi.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Samols
authors.forename: Nathan E
authors.initials: NE
authors.lastname: Smith
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Gerber
authors.forename: Milena
authors.initials: M
authors.lastname: Vuica-Ross
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Burns
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Borowitz
authors.forename: Toby C
authors.initials: TC
authors.lastname: Cornish
authors.forename: Amy S
authors.initials: AS
authors.lastname: Duffield
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057205:Automation, Laboratory / Q000379:methods*; D002467:Cell Nucleus / Q000473:pathology; D049109:Cell Proliferation; D018450:Disease Progression; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008198:Lymph Nodes / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D015203:Reproducibility of Results; D012984:Software
chemical_list: D019394:Ki-67 Antigen
keywords: Automated counting; Follicular lymphoma; Histologic grade; Ki-67; Proliferation index; Quantitation
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