"Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring
"Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring
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DOI：
10.1016/j.humpath.2015.07.008
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发表时间：
2015-11-01
期刊：
影响因子：
3.3
通讯作者：
Cardiff, Robert D.
中科院分区：
文献类型：
--
作者：
Engelberg, Jesse A.;Retallack, Hanna;Cardiff, Robert D.
激素受体状态是乳腺癌管理决策的一个组成部分。IHC4评分是一种结合激素受体、HER2和Ki-67状态的算法，为乳腺癌提供半定量的预后评分。高精度和低观察者间方差是确保准确计算分数的重要因素；然而，以前很少有人努力测量或减少观察者之间的差异。我们开发了一种基于网络的培训工具，称为“Score the Core”（STC），使用组织微阵列训练病理学家直观地对雌激素受体（使用300分H分）、孕激素受体（阳性百分比）和Ki-67（阳性百分比）进行评分。STC使用可重复的人工计数方法计算的参考分数。雅典娜乳腺健康网络的病理学家和相关机构的病理学住院医生完成了这项测试。使用STC后，病理患者的雌激素受体H评分、孕激素受体和Ki-67比例评分均有提高，病理评分与参考评分有较好的相关性。此外，我们收集了病理学家表现的信息，使我们能够比较个别病理学家和一致的措施。病理学家对阳性细胞比例的评估比他们对阳性细胞相对强度的评估更接近参考。应进行仔细的培训和评估，以确保乳腺生物标志物的准确性。随着乳腺癌诊断变得越来越定量和可重复性，这一点尤为重要。我们的培训工具是病理学家培训的一种新方法，可以作为持续质量评估的重要组成部分，并可以提高乳腺癌预后生物标志物的准确性。(C) 2015爱思唯尔公司版权所有。
Hormone receptor status is an integral component of decision-making in breast cancer management. IHC4 score is an algorithm that combines hormone receptor, HER2, and Ki-67 status to provide a semiquantitative prognostic score for breast cancer. High accuracy and low interobserver variance are important to ensure the score is accurately calculated; however, few previous efforts have been made to measure or decrease interobserver variance. We developed a Web-based training tool, called "Score the Core" (STC) using tissue microarrays to train pathologists to visually score estrogen receptor (using the 300-point H score), progesterone receptor (percent positive), and Ki-67 (percent positive). STC used a reference score calculated from a reproducible manual counting method. Pathologists in the Athena Breast Health Network and pathology residents at associated institutions completed the exercise. By using STC, pathologists improved their estrogen receptor H score and progesterone receptor and Ki-67 proportion assessment and demonstrated a good correlation between pathologist and reference scores. In addition, we collected information about pathologist performance that allowed us to compare individual pathologists and measures of agreement. Pathologists' assessment of the proportion of positive cells was closer to the reference than their assessment of the relative intensity of positive cells. Careful training and assessment should be used to ensure the accuracy of breast biomarkers. This is particularly important as breast cancer diagnostics become increasingly quantitative and reproducible. Our training tool is a novel approach for pathologist training that can serve as an important component of ongoing quality assessment and can improve the accuracy of breast cancer prognostic biomarkers. (C) 2015 Elsevier Inc. All rights reserved.