Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Gynecology and Obstetrics, Tuebingen University, Tuebingen, Germany.
Histopathology. 2013 Nov;63(5):704-12. doi: 10.1111/his.12219. Epub 2013 Sep 2.
The recent recognition that ovarian carcinoma is composed of five distinct disease entities has served to increase the value of accurate histotyping. Reliable identification of histotypes is essential for the success of studies testing novel therapies, as well as for biomarker discovery research. The aim of this study was to examine the utility of a nine-marker immunohistochemical (IHC) panel, designated the Calculator for Ovarian Subtype Prediction (COSP), to reliably reproduce the consensus diagnosis of two expert gynaecological pathologists.
A total of 423 cases from the AGO-OVAR11 trial were evaluated using the COSP IHC panel, and compared to original diagnoses from >100 local contributing pathologists and independent expert gynaecopathology review. The overall concordance between COSP and expert review was 89%; in cases where a local pathologist's diagnosis was confirmed by COSP, the expert gynaecopathologist also agreed in 97.5% of cases.
The incorporation of COSP into a high-throughput diagnostic review algorithm will decrease the need for expert review by identifying a small number of difficult cases that truly require expert review. This modification will serve to increase the efficiency of the diagnostic review process, which will probably serve to reduce operational costs and expedite translational studies on ovarian carcinoma.
最近认识到卵巢癌由五个不同的疾病实体组成，这增加了准确组织分型的价值。可靠的组织分型识别对于测试新疗法的研究以及生物标志物发现研究的成功至关重要。本研究旨在检验九标志物免疫组织化学（IHC）检测 panel（称为卵巢亚型预测计算器，COSP）的效用，以可靠地再现两名妇科病理学家专家的共识诊断。
共对 AGO-OVAR11 试验中的 423 例病例使用 COSP IHC panel 进行评估，并与 >100 位当地病理学家的原始诊断和独立妇科病理专家审查进行比较。COSP 与专家审查之间的总体一致性为 89%；在 COSP 确认当地病理学家诊断的病例中，妇科病理专家在 97.5%的病例中也表示同意。
将 COSP 纳入高通量诊断审查算法中，通过识别确实需要专家审查的少数疑难病例，将减少对专家审查的需求。这种修改将提高诊断审查过程的效率，可能会降低运营成本并加快卵巢癌的转化研究。
