Discipline of Pathology, National University of Ireland, Galway, Ireland.
Pathology Department, UDIAT, Centre Diagnostic, Corporacio Sanitaria del Parc Taulí-Institut Universitari Parc Taulí-UAB, Sabadell, Spain.
Breast Cancer Res Treat. 2018 Aug;171(1):1-9. doi: 10.1007/s10549-018-4825-8. Epub 2018 May 17.
BACKGROUND: Several studies have demonstrated a prognostic role for stromal tumour infiltrating lymphocytes (sTILs) in triple-negative breast cancer (TNBC). The reproducibility of scoring sTILs is variable with potentially excellent concordance being achievable using a software tool. We examined agreement between breast pathologists across Europe scoring sTILs on H&E-stained sections without software, an approach that is easily applied in clinical practice. The association between sTILs and response to anthracycline-taxane NACT was also examined. METHODOLOGY: Pathologists from the European Working Group for Breast Screening Pathology scored sTILs in 84 slides from 75 TNBCs using the immune-oncology biomarker working group guidance in two circulations. There were 16 participants in the first and 19 in the second circulation. RESULTS: Moderate agreement was achieved for absolute sTILs scores (intraclass correlation coefficient (ICC) = 0.683, 95% CI 0.601-0.767, p-value < 0.001). Agreement was less when a 25% threshold was used (ICC 0.509, 95% CI 0.416-0.614, p-value < 0.001) and for lymphocyte predominant breast cancer (LPBC) (ICC 0.504, 95% CI 0.412-0.610, p-value < 0.001). Intra-observer agreement was strong for absolute sTIL values (Spearman ρ = 0.727); fair for sTILs ≥ 25% (κ = 0.53) and for LPBC (κ = 0.49), but poor for sTILs as 10% increments (κ = 0.24). Increasing sTILs was significantly associated with an increased likelihood of a pathological complete response (pCR) on multivariable analysis. CONCLUSION: Increasing sTILs in TNBCs improves the likelihood of a pCR. However, inter-observer agreement is such that H&E-based assessment is not sufficiently reproducible for clinical application. Other methodologies should be explored, but may be at the cost of ease of application.
背景:多项研究表明,三阴性乳腺癌(TNBC)中基质肿瘤浸润淋巴细胞(sTILs)具有预后作用。sTILs 的评分重复性因使用软件工具而存在差异,其一致性潜在地非常好。我们检查了欧洲的乳腺病理学家在没有软件的情况下对 H&E 染色切片进行 sTILs 评分的一致性,这种方法在临床实践中很容易应用。还检查了 sTILs 与蒽环类药物-紫杉烷新辅助化疗(NACT)反应之间的关系。 方法:欧洲乳腺筛查病理学工作组的病理学家使用免疫肿瘤生物标志物工作组的指导,在两轮循环中对 75 例 TNBC 的 84 张幻灯片中的 sTILs 进行评分。第一轮有 16 名参与者,第二轮有 19 名参与者。 结果:绝对 sTILs 评分的中度一致性(组内相关系数(ICC)=0.683,95%置信区间(CI)0.601-0.767,p 值<0.001)。当使用 25%的阈值时,一致性降低(ICC 0.509,95%CI 0.416-0.614,p 值<0.001),并且对于淋巴细胞为主型乳腺癌(LPBC)(ICC 0.504,95%CI 0.412-0.610,p 值<0.001)。绝对 sTIL 值的观察者内一致性较强(Spearman ρ=0.727);sTILs≥25%(κ=0.53)和 LPBC(κ=0.49)的一致性中等,而 sTILs 以 10%递增的一致性较差(κ=0.24)。在多变量分析中,sTILs 的增加与病理完全缓解(pCR)的可能性增加显著相关。 结论:TNBC 中 sTILs 的增加提高了 pCR 的可能性。然而,观察者间的一致性使得基于 H&E 的评估在临床应用中不够可重复。应该探索其他方法,但可能会以应用的便利性为代价。
Transl Breast Cancer Res. 2024-11-27
J Pathol Inform. 2024-11-16
Cancers (Basel). 2024-8-20
Transl Breast Cancer Res. 2023-10-23