Mitosis counting—A need for reappraisal

Ellis, Peter Smith; Whitehead, R.

doi:10.1016/s0046-8177(81)80235-3

Cited by 133 publications

(39 citation statements)

References 1 publication

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“…This has been shown to be incorrect, with TMR expressed as the number of mitoses/10 HPF varying by as much as 600%, depending on the microscope used. 13 The policy of histopathologists from the Department of Anatomical Pathology at the Royal Prince Alfred Hospital is to count the total number of mitoses/mm 2 in the dermal area of the tumor with the highest TMR. This latter method is in accordance with the recommendations of the 1982 Pathology Workshop.…”

Section: Discussionmentioning

confidence: 99%

Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Azzola

Shaw

Thompson

et al. 2003

Cancer

379

217

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BACKGROUNDThe current study was performed to determine whether tumor mitotic rate (TMR) is a useful, independent prognostic factor in patients with localized cutaneous melanoma.METHODSFrom the Sydney Melanoma Unit database, 3661 patients with complete clinical information and details of primary tumor thickness, ulcerative state, and TMR were studied. TMR was expressed as mitoses per mm2 in the dermal part of the tumor in which most mitoses were seen, as recommended in the 1982 revision of the 1972 Sydney classification of malignant melanoma. To determine which was the more prognostically useful method of grouping TMR, two separate methods (A and B) were used. Factors predicting melanoma‐specific survival were analyzed using the Cox proportional hazards regression model.RESULTSPatients with a TMR of 0 mitoses/mm2 had a significantly better survival than those with 1 mitosis/mm2 (P < 0.0001) but no significant survival differences were recorded for the stepwise increases from 1–2, 2–3, 3–4, and 4–5/mm2. Tumor thickness, ulceration, and TMR were closely correlated, whether TMR was grouped using Method A (0, 1–4, 5–10, and ≥ 11 mitoses/mm2) or Method B (0–1, 2–4, and ≥ 5 mitoses/mm2). However, Cox regression analysis indicated that the TMR was a highly significant independent prognostic factor, particularly when grouped according to Method A, in which it was second only to tumor thickness as the most powerful predictor of survival (P < 0.0001).CONCLUSIONSTMR is an important independent predictor of survival for melanoma patients. If confirmed by studies from other centers, it has the potential to further improve the accuracy of melanoma staging, as well as to define more rigidly the risk categories for patients entering clinical trials. Cancer 2003;97:1488–98. © 2003 American Cancer Society.DOI 10.1002/cncr.11196

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Section: Discussionmentioning

confidence: 99%

Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Azzola

Shaw

Thompson

et al. 2003

Cancer

379

217

View full text Add to dashboard Cite

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“…Although several methods have been used to determine the tumor proliferative fraction in the research setting, the only practical methods used in the pathology laboratory were Ki-67 and mitotic count (2). Mitotic count was long used by surgical pathologists as diagnostic and prognostic criteria in malignant tumors, but is subjective, has poor reproducibility and is dependent on laboratory techniques (3)(4)(5).…”

Section: Ki-67 As a Proliferative Markermentioning

confidence: 99%

“…While the mitotic count is an important component of the classification of pulmonary neuroendocrine tumors, it can be difficult to assess in limited biopsies. Mitoses can be difficult to distinguish from apoptotic cells and may be obscured by crush artefact (4,(44)(45)(46). Also, evaluating mitotic count is time consuming and is subject to interobserver variability (37).…”

Section: Ki-67 In Pulmonary Neuroendocrine Tumorsmentioning

confidence: 99%

Ki-67 expression in pulmonary tumors

Chirieac

2016

Transl. Lung Cancer Res.

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“…The mitotic index is usually expressed as the number of mitotic figures per 10 high power fields [6]. Although counting mitoses would appear to be an entirely objective procedure, many factors can affect the final mitotic count [4][5][6][7][8][9]. Some authors have used a combination of mitotic activity and nuclear atypia to improve the accuracy of the diagnosis.…”

mentioning

confidence: 99%

A new scoring system using multiple immunohistochemical markers for diagnosis of uterine smooth muscle tumors

Rath‐Wolfson

Rosenblat

Halpern

et al. 2006

J Cellular Molecular Medi

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Leiomyomas are common benign smooth muscle tumors occurring in nearly 40% of women older than 35 years of age. The types in terms of histological criteria consist of usual leiomyoma (UL), cellular leiomyoma (CL), atypical leiomyoma (AL), and smooth muscle tumors of uncertain malignant potential (STUMP). In contrast, leiomyosarcomas (LMS) are rare tumors accounting for 0.21-6% of all smooth muscle tumors of the uterus with a peak incidence in the fifth decade [1]. The risk of local recurrence and metastasis is high in LMS and the reported 5 year AbstractThe diagnosis of uterine smooth muscle neoplasms by light microscopy is difficult. Multiple classification schemes have been proposed based on mitotic rate, nuclear atypia, and the presence or absence of necrosis. None of these classification systems has been entirely successful. This study was undertaken to evaluate the use of selected immunohistochemical and histochemical markers in differentiating these tumors, in addition to accepted morphologic criteria. Ten cases of each of the following: leiomyosarcomas (LMS), atypical leiomyomas (AL), cellular leiomyomas (CL) and usual leiomyomas (UL), were classically evaluated for histological diagnosis and were stained for Ki-67 (MIB-1), bcl-2 and p53 using monoclonal antibodies and the avidin-biotin peroxidase method, and argyrophilic nucleolar organizer region (AgNORs). The number of stained cells was counted in the most positively stained region in a 4 mm 2 square cover glass mounted on each slide. The mean value was calculated for each group of tumors. The data for Ki-67 (MIB-1), bcl-2, p53 and AgNOR staining respectively, were significantly higher in LMS by comparison to UL, CL or AL. Because many singular cases had superimposed data being difficult to diagnose, a new scoring system for pathological evaluation was created. The results obtained by this scoring system suggest that immunohistochemical markers Ki-67 (MIB-1), bcl-2, p53 together with the AgNOR staining could be useful, by the scoring system, as an adjunct to the current accepted morphologic criteria in differentiating smooth muscle tumors of the uterus.

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Mitosis counting—A need for reappraisal

Cited by 133 publications

References 1 publication

Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Tumor mitotic rate is a more powerful prognostic indicator than ulceration in patients with primary cutaneous melanoma

Ki-67 expression in pulmonary tumors

A new scoring system using multiple immunohistochemical markers for diagnosis of uterine smooth muscle tumors

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