Comparison between digital image analysis and visual assessment of immunohistochemical HER2 expression in breast cancer
Comparison between digital image analysis and visual assessment of immunohistochemical HER2 expression in breast cancer
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DOI：
10.1016/j.prp.2018.10.015
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发表时间：
2018-12-01
影响因子：
2.8
通讯作者：
Keelawat, Somboon
中科院分区：
文献类型：
--
作者：
Jakobsen, Morten Ragn;Teerapakpinyo, Chinachote;Keelawat, Somboon
背景资料：评估HER 2状态被认为是乳腺癌组织病理学检查中的标准治疗，并传达用于指导治疗决策的预后和预测信息。评估通常分两步进行，首先通过常规显微镜检查评估HER 2蛋白的免疫组化表达，然后通过原位杂交技术进一步分析可疑病例，以评估基因扩增状态。在这项研究中，我们比较了传统的手工评估的免疫组化HER 2表达与数字图像分析（DIA）和共识的手工评估由一个小组的三个pathologist.Methods：从我们的档案中，我们检索了109浸润性乳腺癌的切片染色HER 2与相应的HER 2评分从原始病理报告。由三位病理学家对载玻片进行评估，以达到一致评分。接下来，将载玻片扫描成整个载玻片图像，并使用Aperio Imagescope进行DIA。结果：人工评估与一致性评估和DIA比较，人工评估与一致性评估和DIA的加权Kappa系数分别为0.79和0.67，两者具有较好的一致性。当与DISH的基因状态评估相比时，一致性分析得出加权kappa系数为0.52（手动vs. DISH）、0.58（共识vs. DISH）和0.78（DIA vs. DISH）。三种方法均无假阴性，假阳性率为0.9 - 2.8%。每种方法的可疑病例比例分别为44%（手动）、33.3%（共识）和14.7%（DIA）。DIA的应用减少了67%的可疑病例的数量，而不增加假阴性的比例。结论：我们得出结论，DIA是一种准确的方法，以减少HER 2可疑病例的数量，而不影响HER 2评估的敏感性。
Background: Assessment of HER2 status is considered standard of care in the histopathologic workup of breast cancer and conveys prognostic and predictive information used to guide treatment decisions. The assessment is often carried out in a two-step approach where immunohistochemical expression of HER2 protein is first evaluated by conventional microscopy and equivocal cases are further analyzed by in-situ hybridization techniques to assess gene amplification status. In this study we compared conventional manual assessment of immunohistochemical HER2 expression with digital image analysis (DIA) and consensus manual assessment by a panel of three pathologists.Methods: From our archive we retrieved sections of 109 invasive breast carcinomas stained for HER2 with corresponding HER2 score from the original pathology report. The glass slides were assessed by three pathologists to reach a consensus score. Next, the slides were scanned into whole slide images and DIA was performed using Aperio Imagescope. The scoring results were then compared with gene amplification status evaluated by dual in-situ hybridization (DISH).Results: Comparing manual assessment with consensus assessment and DIA, good agreement was obtained with weighted kappa coefficients of 0.79 (manual vs. consensus) and 0.67 (manual vs. DIA). When compared with gene status assessment by DISH, agreement analysis yielded weighted kappa coefficients of 0.52 (manual vs. DISH), 0.58 (consensus vs. DISH) and 0.78 (DIA vs. DISH). There were no false negatives by any of the three methods and false positives ranging from 0.9 to 2.8%. The proportion of equivocal cases by each method was 44% (manual), 33.3% (consensus) and 14.7% (DIA). Application of DIA reduced the number of equivocal cases by 67% without increasing the proportion of false negatives.Conclusion: We conclude that DIA is an accurate method to reduce the number of HER2 equivocal cases without affecting the sensitivity of the HER2 assessment.