Multi-Institutional Evaluation of Pathologists’ Assessment Compared to Immunoscore
(2023) Cancers — Vol. 15, n° 16, p. 4045 [1-18] (2023)
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Torigoe, Toshihiko 
Hirohashi, Yoshihiko
- Abstract
- (en) 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.
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Willis, J., Anders, R. A., Torigoe, T., Hirohashi, Y., Bifulco, C., Zlobec, I., Mlecnik, B., Demaria, S., Choi, W.-T., Dundr, P., Tatangelo, F., Di Mauro, A., Baldin, P., Bindea, G., Marliot, F., Haicheur, N., Fredriksen, T., Kirilovsky, A., Buttard, B., et al. (2023). Multi-Institutional Evaluation of Pathologists’ Assessment Compared to Immunoscore. Cancers, 15(16), 4045 [1-18]. https://doi.org/10.3390/cancers15164045 (Original work published 2023)