University Clinic for Dermatology, Johannes Wesling Medical Centre, Minden, Germany.
University Hospital of Ruhr-University, Bochum, Germany.
Am J Dermatopathol. 2023 Feb 1;45(2):93-98. doi: 10.1097/DAD.0000000000002330.
Mycosis fungoides is the most common subtype of cutaneous T-cell lymphoma, in which the expression of cluster of differentiation 30 (CD30)+ subtype can now be treated with the CD30 antibody conjugate brentuximab vedotin. Diagnostic methods are based on immunohistochemical (IHC) staining followed by manual assessment by pathologists, which is always a subjective calculation. QuPath, an open-source software for digital pathology image analysis, satisfies the requirements of objective approaches.
Ten samples from mycosis fungoides patients with CD30 expression at different stages were stained for CD3 and CD30 by IHC staining, scanned, and quantitative analysis was performed using QuPath (version 2.1). Each slide was independently assessed by 3 board-certified dermatopathologists.
Individual estimates for CD30+/CD3+ cells varied among the individual histopathologists (mean coefficient of variation, 0.46; range, 0-0.78). QuPath analysis showed excellent separation between the positively stained cells for CD3 and CD30 IHC and other cells and tissue structures, although the results correlated strongly with the respective mean estimates of the 3 histopathologists (Pearson-R 0.93).
The results show a high interobserver variability evaluation of IHC markers, although quantitative image analysis offer a significant advantage for comparison. This is not only relevant for clinical routine but also especially critical in therapeutic studies addressing targeted molecules.
蕈样肉芽肿是皮肤 T 细胞淋巴瘤最常见的亚型，现在可以用 CD30 抗体偶联药物 Brentuximab vedotin 治疗表达 CD30+亚型的患者。诊断方法基于免疫组织化学（IHC）染色，然后由病理学家进行手动评估，这始终是一种主观计算。QuPath 是一种用于数字病理学图像分析的开源软件，满足客观方法的要求。
10 例不同阶段蕈样肉芽肿患者的 CD30 表达样本进行 CD3 和 CD30 的 IHC 染色，扫描并使用 QuPath（版本 2.1）进行定量分析。每位病理学家均独立评估每张幻灯片。
个别组织病理学家对 CD30+/CD3+细胞的个体估计值存在差异（平均变异系数为 0.46；范围为 0-0.78）。尽管 QuPath 分析显示 CD3 和 CD30 IHC 阳性染色细胞与其他细胞和组织结构之间有很好的分离，但与 3 位组织病理学家各自的平均估计值相关性很强（Pearson-R 0.93）。
结果表明，IHC 标志物的观察者间变异性评估很高，尽管定量图像分析在比较方面具有显著优势。这不仅与临床常规相关，而且在针对靶向分子的治疗研究中尤其关键。
