Multi-Institutional Evaluation of Pathologists' Assessment Compared to Immunoscore.
Joseph Willis1, Robert A Anders2, Toshihiko Torigoe3
1Department of Pathology, UH Cleveland Medical Center, Cleveland, OH 44106, USA.
Cancers
|August 26, 2023
Summary
The standardized Immunoscore (IS) assay for cancer immunity is more reproducible than expert pathologists' visual assessment. Digital pathology offers a new generation of immune cell analysis tools.
Area of Science:
- Immunology
- Digital Pathology
- Oncology
Background:
- The Immunoscore (IS) is a digital pathology assay for quantifying immune response in cancer patients.
- Reproducibility of visual assessment of immune cell infiltration by pathologists is crucial for cancer diagnosis and treatment.
Purpose of the Study:
- To compare the reproducibility of pathologists' visual assessment of CD3+ and CD8+ immune cells in colon tumors with the quantitative Immunoscore (IS) assay.
- To evaluate the concordance between visual T-scores and digital IS quantification for two- and three-category IS classifications.
Main Methods:
- An international panel of expert pathologists evaluated 540 images from 270 colon cancer cases.
- Concordance analysis was performed between pathologists' T-scores, H&E slides, and digital IS results.
- Reproducibility was assessed before and after a training intervention.
Main Results:
- Over 92% of cases showed non-concordant T-scores between pathologists.
- Disagreement between visual assessment and digital IS was high (91-96%), even after training.
- Concordance index between pathologists and digital IS was weak, with no significant improvement post-training (Kappa values < 0.47).
Conclusions:
- The standardized Immunoscore assay demonstrates superior reproducibility compared to expert pathologists' visual T-score evaluation.
- Digital pathology, specifically the Immunoscore assay, represents a next-generation tool for reproducible and quantitative immune cell analysis in tumors.
