非小细胞肺癌细胞学细胞块标本中程序性死亡配体 1 免疫组织化学评分。
Scoring of Programmed Death-Ligand 1 Immunohistochemistry on Cytology Cell Block Specimens in Non-Small Cell Lung Carcinoma.
机构信息
Department of Pathology, Department of Population Health, NYU Langone Health, New York, NY.
Division of Biostatistics, Department of Population Health, NYU Langone Health, New York, NY.
出版信息
Am J Clin Pathol. 2020 Sep 8;154(4):517-524. doi: 10.1093/ajcp/aqaa073.
OBJECTIVES
Recent investigations have shown strong correlations between cytology and surgical non-small cell lung carcinoma (NSCLC) specimens in programmed death-ligand 1 (PD-L1) immunohistochemical (IHC) evaluations. Our study aims to evaluate the reproducibility of PD-L1 IHC scoring in NSCLC cytology cell blocks (CBs) and to assess the impact of CB cellularity, method of sample collection, and observer subspecialty on scoring agreement.
METHODS
PD-L1 IHC was performed on 54 NSCLC cytology CBs and was scored independently by seven cytopathologists (three of seven with expertise in pulmonary pathology). Three-tier scoring of negative (<1%), low positive (1%-49%), and high positive (≥50%) and interrater agreement were assessed.
RESULTS
Total and majority agreement among cytopathologists was achieved in 48% and 98% of cases, respectively, with κ = 0.608 (substantial agreement; 95% confidence interval, 0.50-0.72). Cytopathologists with pulmonary pathology expertise agreed in 67% of cases (κ = 0.633, substantial agreement), whereas the remaining cytopathologists agreed in 56% of cases (κ = 0.62, substantial agreement). CB cellularity (P = .36) and sample collection type (P = .59) had no statistically significant difference between raters.
CONCLUSIONS
There is substantial agreement in PD-L1 IHC scoring in cytology CB specimens among cytopathologists. Additional expertise in pulmonary pathology, sample collection type, and CB cellularity have no statistically significant impact on interobserver agreement.
目的
最近的研究表明，细胞学和手术非小细胞肺癌（NSCLC）标本在程序性死亡配体 1（PD-L1）免疫组织化学（IHC）评估中存在很强的相关性。本研究旨在评估 NSCLC 细胞学细胞块（CB）中 PD-L1 IHC 评分的可重复性，并评估 CB 细胞数量、样本采集方法和观察者专业领域对评分一致性的影响。
方法
对 54 例 NSCLC 细胞学 CB 进行 PD-L1 IHC 检测，由 7 位细胞病理学家（7 位中有 3 位具有肺部病理学专业知识）独立进行评分。评估了阴性（<1%）、低阳性（1%-49%）和高阳性（≥50%）的三分制评分和观察者间一致性。
结果
在 48%的病例中，细胞病理学家之间达到了总一致性，在 98%的病例中达到了主要一致性，κ=0.608（高度一致；95%置信区间，0.50-0.72）。具有肺部病理学专业知识的细胞病理学家在 67%的病例中达成一致（κ=0.633，高度一致），而其余细胞病理学家在 56%的病例中达成一致（κ=0.62，高度一致）。细胞块的细胞数量（P=0.36）和样本采集类型（P=0.59）在评分者之间没有统计学上的显著差异。
结论
在细胞学 CB 标本中，PD-L1 IHC 评分在细胞病理学家之间具有高度的一致性。在肺部病理学、样本采集类型和 CB 细胞数量方面的额外专业知识对观察者间的一致性没有统计学上的显著影响。
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