Automated quantitative analysis of estrogen receptor expression in breast carcinoma does not differ from expert pathologist scoring: a tissue microarray study of 3,484 cases
Automated quantitative analysis of estrogen receptor expression in breast carcinoma does not differ from expert pathologist scoring: a tissue microarray study of 3,484 cases
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DOI：
10.1007/s10549-007-9736-z
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发表时间：
2008-08-01
影响因子：
3.8
通讯作者：
Huntsman, David G.
中科院分区：
文献类型：
--
作者：
Turbin, Dmitry A.;Leung, Samuel;Huntsman, David G.
背景：雌激素受体（ER）的表达通常通过免疫组织化学（IHC）来评估。我们的研究比较了视觉评分ER在浸润性乳腺癌组织病理学家定量染色using a fully automated system.Materials and Methods A组织微阵列构建4,049例（3,484包括在分析）浸润性乳腺癌的治疗和结果的信息。由两名病理学家独立地对载玻片进行评分，并将评分二分，其中ER阳性在> 1%阳性核的截止值处被识别。结果使用ER阳性或阴性的二分数据，视觉评分和自动评分高度一致：两名病理学家之间（kappa = 0.918（95%CI：0.903-0.932））和两台Ariol机器之间（kappa = 0.913（95%CI：0.897-0.928））有很好的一致性。ER阳性的预后意义是相似的，无论是由病理学家或自动评分的整个患者队列和亚组的患者单独接受他莫昔芬治疗或接受全身辅助治疗。使用乳腺癌疾病特异性生存作为终点的自动评分的最佳临界点是> 0.4%阳性核。右旋糖酐包被活性炭ER生化检测数据与自动评分的一致性（kappa = 0.728（95%CI：0.69-0.75）; 0.74（95%CI：0.71-0.77））与生化分析和病理学家评分之间的一致性相似（kappa = 0.72（95%CI：0.70-0.75; 0.70（95%CI：0.67-0.72））。结论ER免疫染色的全自动定量产生的结果与针对生化测定和患者结果金标准的人类评分没有差异。
Background Estrogen receptor (ER) expression is routinely assessed by immunohistochemistry (IHC) in breast carcinoma. Our study compares visual scoring of ER in invasive breast cancer by histopathologists to quantitation of staining using a fully automated system.Materials and methods A tissue microarray was constructed from 4,049 cases (3,484 included in analysis) of invasive breast carcinoma linked to treatment and outcome information. Slides were scored independently by two pathologists and scores were dichotomised, with ER positivity recognized at a cut-off of > 1% positive nuclei. The slides were scanned and analyzed with an Ariol automated system.Results Using data dichotomised as ER positive or negative, both visual and automated scores were highly consistent: there was excellent concordance between two pathologists (kappa = 0.918 (95%CI: 0.903-0.932)) and between two Ariol machines (kappa = 0.913 (95%CI: 0.897-0.928)). The prognostic significance of ER positivity was similar whether determined by pathologist or automated scoring for both the entire patient cohort and subsets of patients treated with tamoxifen alone or receiving no systemic adjuvant therapy. The optimal cut point for the automated scores using breast cancer disease-specific survival as an endpoint was > 0.4% positive nuclei. The concordance between dextran-coated charcoal ER biochemical assay data and automated scores (kappa = 0.728 (95%CI: 0.69-0.75); 0.74 (95%CI: 0.71-0.77)) was similar to the concordance between biochemical assay and pathologist scores (kappa = 0.72 (95%CI: 0.70-0.75; 0.70 (95%CI: 0.67-0.72)).Conclusion Fully automated quantitation of ER immunostaining yields results that do not differ from human scoring against both biochemical assay and patient outcome gold standards.