Title of article :
Tumor Digital Masking Allows Precise Patient Triaging: A StudyBased on Ki-67 Scoring in Gastrointestinal Stromal Tumors
Author/Authors :
Lewitowicz, Piotr Department of Pathology - Faculty of Medicine and Health Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Matykiewicz, Jaroslaw Department of Surgery and Surgical Nursing - Faculty of Medicine and Health Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Koziel, Dorota Department of Surgery and Surgical Nursing - Faculty of Medicine and Health Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Gluszek , Stanisław Department of Surgery and Surgical Nursing - Faculty of Medicine and Health Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Wawrzycka, Iwona Department of Surgery and Surgical Nursing - Faculty of Medicine and Health Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Chrapek, Magdalena Department of Probability Theory and Statistics - Institute of Mathematics - The Faculty of Mathematics and Natural Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Horecka-Lewitowicz, Agata Department of Public Health, Faculty of Medicine and Heath Sciences - Jan Kochanowski University in Kielce - Kielce, Poland , Gluszek-Osuch, Martyna Department of Public Health, Faculty of Medicine and Heath Sciences - Jan Kochanowski University in Kielce - Kielce, Poland
Abstract :
Technologicaladvancesconstantlyprovidecutting-edgetoolsthatenhancetheprogressofdiagnosticcapabilities. Gastrointestinalstromaltumorsbelongtoafamilyofmesenchymaltumorswherepatienttriagingisstillbasedontraditionalcriteriasuchasmitoticcount,tumorsize,andtumorlocation.Limitationsofthehumaneyeandrandomnessinchoiceofareaformitoticfigurecountingcompelustoseekmoreobjectivesolutionssuchasdigitalimageanalysis.Presently,thelabellingofproliferativeactivityisbecomingaroutinetaskamidstmanycancers.Thepurposeofthepresentstudywastocomparethetraditionalmethodofpredictionbasedonmitoticratiowithdigitalimageanalysisofcellcycle-dependentproteins.Methods.Fifty-seveneligiblecaseswereenrolled.Furthermore,adigitalanalysisofpreviouslyperformedwholetissuesectionimmunohistochemicalassayswasexecuted.Digitallabellingcoveredbothhotspotsandnot-hotspotsequally.Results.Wenotedasignificantdiversityofproliferativeactivities,andconsequently,theresultspointedto6.5% ofKi-67,countedinhotspots,astheoptimalcut-offforlow–high-gradeGIST.ROCanalysis (AUC=0.913;95%CI:0.828–0.997,p<000001)andoddsratio(OR=40.0,95%CI:6.7–237.3,p<00001)pointedtoKi-6716%asthecut-offforveryhigh-grade(groups5–6)cases. Withhelpofatumordigitalmap,werevealedpossibleerrorsresultingfromawrongchoiceoffieldforanalysis.WeconfirmedthatKi-67scoresareinlinewiththelevelofintracellularmetabolismthatcouldbeusedastheadditionalbiomarker. Conclusions.Tumordigitalmaskingisverypromisingsolutionforrepeatableandobjectivelabelling.Softwareadjustmentsofnuclearshape,outlines,size,etc. arehelpfultoomitotherKi-67-positivecellsespeciallysmalllymphocytes. OurresultspointedtoKi-67asagoodbiomarkerin GIST,butconcurrently,wenotedsignificantdifferencesinuseddigitalapproacheswhichcouldleadtounequivocalresults
Keywords :
Tumor Digital Masking , Precise Patient Triaging , Study Based , Ki-67 Scoring , Gastrointestinal Stromal Tumors , GIST
