학술논문
Multi-Institutional Evaluation of Pathologists’ Assessment Compared to Immunoscore
Document Type
article
Author
Joseph Willis; Robert A. Anders; Toshihiko Torigoe; Yoshihiko Hirohashi; Carlo Bifulco; Inti Zlobec; Bernhard Mlecnik; Sandra Demaria; Won-Tak Choi; Pavel Dundr; Fabiana Tatangelo; Annabella Di Mauro; Pamela Baldin; Gabriela Bindea; Florence Marliot; Nacilla Haicheur; Tessa Fredriksen; Amos Kirilovsky; Bénédicte Buttard; Angela Vasaturo; Lucie Lafontaine; Pauline Maby; Carine El Sissy; Assia Hijazi; Amine Majdi; Christine Lagorce; Anne Berger; Marc Van den Eynde; Franck Pagès; Alessandro Lugli; Jérôme Galon
Source
Cancers, Vol 15, Iss 16, p 4045 (2023)
Subject
Language
English
ISSN
2072-6694
Abstract
Background: The Immunoscore (IS) is a quantitative digital pathology assay that evaluates the immune response in cancer patients. This study reports on the reproducibility of pathologists’ visual assessment of CD3+- and CD8+-stained colon tumors, compared to IS quantification. Methods: An international group of expert pathologists evaluated 540 images from 270 randomly selected colon cancer (CC) cases. Concordance between pathologists’ T-score, corresponding hematoxylin–eosin (H&E) slides, and the digital IS was evaluated for two- and three-category IS. Results: Non-concordant T-scores were reported in more than 92% of cases. Disagreement between semi-quantitative visual assessment of T-score and the reference IS was observed in 91% and 96% of cases before and after training, respectively. Statistical analyses showed that the concordance index between pathologists and the digital IS was weak in two- and three-category IS, respectively. After training, 42% of cases had a change in T-score, but no improvement was observed with a Kappa of 0.465 and 0.374. For the 20% of patients around the cut points, no concordance was observed between pathologists and digital pathology analysis in both two- and three-category IS, before or after training (all Kappa < 0.12). Conclusions: The standardized IS assay outperformed expert pathologists’ T-score evaluation in the clinical setting. This study demonstrates that digital pathology, in particular digital IS, represents a novel generation of immune pathology tools for reproducible and quantitative assessment of tumor-infiltrated immune cell subtypes.