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Mitotic counting in surgical pathology: sampling bias, heterogeneity and statistical uncertainty
Author(s) -
Thunnissen F B J M,
Ambergen A W,
Koss M,
Travis W D,
O'Leary T J,
Ellis I O
Publication year - 2001
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1046/j.1365-2559.2001.01187.x
Subject(s) - sampling (signal processing) , mitotic index , mitosis , selection (genetic algorithm) , protocol (science) , pathology , statistics , biology , computer science , medicine , mathematics , artificial intelligence , alternative medicine , filter (signal processing) , computer vision , microbiology and biotechnology
Mitotic counting in surgical pathology: sampling bias, heterogeneity and statistical uncertainty Although several articles on the methodological aspects of mitotic counting have been published, the effects of macroscopic sampling and tumour heterogeneity have not been discussed in any detail. In this review the essential elements for a standardized mitotic counting protocol are described, including microscopic calibration, specific morphological criteria, macroscopic selection, counting procedure, effect of biological variation, threshold, and the setting of an area of uncertainty (‘grey area’). We propose that the use of a standard area for mitotic quantification and of a grey area in mitotic counting protocols will facilitate the application of mitotic counting in diagnostic and prognostic pathology.