How reliable is Ki-67 immunohistochemistry in grade 2 breast carcinomas? A QA study of the Swiss Working Group of Breast- and Gynecopathologists

Adjuvant chemotherapy decisions in breast cancer are increasingly based on the pathologist's assessment of tumor proliferation. The Swiss Working Group of Gyneco- and Breast Pathologists has surveyed inter- and intraobserver consistency of Ki-67-based proliferative fraction in breast carcinomas. Methods Five pathologists evaluated MIB-1-labeling index (LI) in ten breast carcinomas (G1, G2, G3) by counting and eyeballing. In the same way, 15 pathologists all over Switzerland then assessed MIB-1-LI on three G2 carcinomas, in self-selected or pre-defined areas of the tumors, comparing centrally immunostained slides with slides immunostained in the different laboratoires. To study intra-observer variability, the same tumors were re-examined 4 months later. Results The Kappa values for the first series of ten carcinomas of various degrees of differentiation showed good to very good agreement for MIB-1-LI (Kappa 0.56–0.72). However, we found very high inter-observer variabilities (Kappa 0.04–0.14) in the read-outs of the G2 carcinomas. It was not possible to explain the inconsistencies exclusively by any of the following factors: (i) pathologists' divergent definitions of what counts as a positive nucleus (ii) the mode of assessment (counting vs. eyeballing), (iii) immunostaining technique, and (iv) the selection of the tumor area in which to count. Despite intensive confrontation of all participating pathologists with the problem, inter-observer agreement did not improve when the same slides were re-examined 4 months later (Kappa 0.01–0.04) and intra-observer agreement was likewise poor (Kappa 0.00–0.35). Conclusion Assessment of mid-range Ki-67-LI suffers from high inter- and intra-observer variability. Oncologists should be aware of this caveat when using Ki-67-LI as a basis for treatment decisions in moderately differentiated breast carcinomas.

Ms. hebr. oct. 67 - Sefer ha-ʾorah

Vorbesitzer: Abraham Merzbacher

Ms. Barth. 67 - De institutione laicali libri III

Vorbesitzer: Dominikanerkloster Frankfurt am Main; Bartholomaeusstift Frankfurt am Main;

Na 1 Nachlass Max Horkheimer, 67 - Korrespondenzen u.a. mit der Columbia University New York (p. II 5, 1-219)

17 Briefe und Beilage zwischen Joseph Christ und Max Horkheimer, 1942-1943; 13 Briefe zwischen Elliot E. Cohen und Max Horkheimer, 1946-1947; 7 Briefe zwischen Stewart G. Cole und Max Horkheimer, 1944-1945 sowie 1 Sonderdruck; 1 Memorandum von Theodor W. Adorno an F. Pollock, 1948; 5 Briefe zwischen dem Collegium [Studentischer Club an der Universität Frankfurt am Main] und Max Horkheimer, 1949; 17 Briefe und Beilage zwischen dem College of Jewish Studies, 1948-1949, 1951 sowie Drucksachen und 9 Papers zum Antisemitismus; 18 Briefe und Beilagen zwischen der Columbia University New York und Max Horkheimer, 1942-1947;

Ms. Praed. 67 - Compendium theologicae veritatis

Vorbesitzer: Radulfus de Zelandia alias de Bruxella; Dominikanerkloster Frankfurt am Main

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 67 - Übersendung einer Publikation

u.a.: beabsichtigtes Treffen am 2. oder 3. Juli 1857 in Frankfurt am Main;

Ms.Ff.F.Stoltze 3. 67 - Brief von Friedrich August Finger an Friedrich Stoltze

Wilhelm Sauerwein: "Der Gräff, wie er leibt und lebt", Georg Friedrich Gräff, Samuel Friedrich Hassel

Ms. Barth. 181 (Ausst. 67) - Evangelistarium

Vorbesitzer: Hartmann Becker; Margarethe von Appenheim; Bartholomaeusstift Frankfurt am Main