Interobserver agreement for estrogen receptor immunohistochemical analysis in breast cancer: a comparison of manual and computer-assisted scoring methods.
Interobserver agreement for estrogen receptor immunohistochemical analysis in breast cancer: a comparison of manual and computer-assisted scoring methods.
复制标题
DOI：
10.1016/j.anndiagpath.2003.11.004
复制
发表时间：
2004-02-01
影响因子：
2
通讯作者：
Sneige, Nour
中科院分区：
文献类型：
--
作者：
Diaz, Leslie K;Sahin, Aysegul;Sneige, Nour
雌激素受体（ER）免疫组化评分方法的差异可能导致结果的显著差异。评分方法在美国和国际上各不相同，包括半定量评分公式、人工估计和计算机辅助技术。本研究的目的是确定我们机构手动ER评分的观察者间变异率，并将手动评分获得的ER评分与使用图像分析软件（QCA，Lake海崖，IL）获得的ER评分进行比较。在一系列的70个连续的浸润性乳腺癌，ER进行了测定，使用标准的免疫组织化学技术和单克隆抗体6F11。由三位乳腺病理学家独立进行评分，并将评分与使用QCA图像分析系统获得的评分进行比较，使用10%核染色作为阳性的截止值。ER阳性43例（61%），阴性25例（36%），ER染色低于10%者2例（3%）。70例病例的一致性评分显示与图像分析确定的ER评分高度一致（kappa = 0.84）。观察者间变异性低。每个观察者的Kappa评分与共识评分、图像分析评分以及观察者之间的一致性非常高。我们的研究结果表明，观察者之间的协议手动评分的ER是强大的，手动或计算机辅助评分技术是可比的。
Differences in scoring methods for estrogen receptor (ER) immunohistochemistry may cause significant variation in the results. Scoring practices differ within the United States and internationally and include semiquantitative scoring formulas, manual estimations, and computer-assisted techniques. The goal of this study was to determine the rate of interobserver variability for manual ER scoring at our institution and compare the ER scores obtained by manual scoring with those obtained using image-analysis software (QCA, Lake Bluff, IL). In a series of 70 consecutive invasive breast cancers, ER was assayed using standard immunohistochemical techniques and the monoclonal antibody 6F11. Scoring was performed independently by three breast pathologists, and the scores were compared with those obtained using the QCA image-analysis system, using 10% nuclear staining as the cutoff for positivity. We found that 43 cases (61%) were ER positive, 25 cases (36%) were ER negative, and two cases (3%) showed ER staining of less than 10%. The consensus scores for the 70 cases showed a high level of agreement with the ER scores determined by image analysis (kappa = 0.84). Interobserver variability was low. The kappa scores for each observer showed strong agreement with the consensus score, the image-analysis score, and between the observers. Our findings show that interobserver agreement for manual scoring of ER is strong, and that manual or computer-aided scoring techniques are comparable.