Abstract P5-10-06: Risk of recurrence estimates with IHC4 are tolerant of variations in staining and scoring
Notice bibliographique
Résumé
Abstract Aims 1. To determine the degree to which alterations in immunohistochemical (IHC) staining for ER, PgR, and Ki67 affect IHC4 scores and distant recurrence estimates. 2. To examine the level of scoring precision needed for accurate use of the IHC4 score. Background The IHC4+clinical (C) score combines assessment of protein expression levels of ER, PgR, HER2 and Ki67 with clinicopathological parameters to identify breast cancer patients at low, intermediate or high risk of distant disease recurrence so aiding treatment decision-making (Cuzick J, et al. JCO 2011;29:4273). The score is used in clinical decision making in our hospital (RMH). Our published studies have shown it provides information that improves decision-making on adjuvant chemotherapy in >65% of patients (Barton S, et al. BrJCancer 2012;106:1760; Yeo BJ, et al. AnnalsOncol 2014;25suppl_1:i2). Despite its low cost and wide availability reported use of IHC4+C in other institutions remains limited (Lakhanpal R, et al. JCO 2014;32:abstr2549); one explanation is the perception that IHC-based methods and the assessment of them lack precision, reproducibility and portability. We have examined the effect of decentralized testing and easily reproduced estimate-based scoring methods on the IHC4 score to determine its suitability for wider adoption. Methods A TMA was constructed from 30 breast cancer cases representative of those for which IHC4+C is requested at RMH. Sections were distributed to three centers that undertake diagnostic breast cancer IHC and that use reagents and platforms from Dako, Leica or Ventana who provide most IHC for oncology globally. Centers carried-out staining using their standard procedures and returned slides for central assessment. Results were compared against those obtained at RMH using standardized methods previously described (Barton S, et al. BrJCancer 2012;106:1760), and were used to calculate IHC4+C and 10-year distant recurrence probability (%DRprob) scores. In parallel the TMA slide stained at RMH for ER was scored by a variety of simplified non-counting based methods. Results were compared with those produced by counted H-Score when used to calculate IHC4+C and %DRprob. Results There was a high-degree of correlation between individual IHC results produced by all three external centers and those of RMH, and of the IHC4 and %DRprob scores derived from them (Tables 1 & 2). Scoring method for ER could be adapted to require less precision without significantly affecting IHC4+C and %DRprob results (correlation coefficients range: 0.90 - 0.98). IHC4%DRprob RMHDakoLeicaRMHDakoLeicaDako0.92 0.97 Leica0.890.95 0.980.98 Ventana0.930.960.950.980.980.98 Table 1. Correlation coefficients for all pair-wise comparisons MeanMedian difference RMHDakoLeicaRMH9.9% Dako8.4%1.0% Leica8.9%0.9%0.5% Ventana9.1%0.6%0.5%0.6% Table 2. Showing for each center, the mean %DRprob score and median value obtained when the absolute difference was calculated between matched scores Conclusion The IHC4+C algorithm is tolerant of variation in staining and ER-scoring method used. Although additional comparative studies are required to confirm them, these data support the use of IHC4+C in routine clinical practice outside its institute of origin. Citation Format: Andrew Dodson, Lila Zabaglo, Belinda Yeo, Keith Miller, Ian Smith, Mitch Dowsett. Risk of recurrence estimates with IHC4 are tolerant of variations in staining and scoring [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-10-06.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,102 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,014 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».