90 p16 IHC Validation on Cytology Cell Blocks
Bibliographic record
Abstract
P16 immunohistochemistry (IHC) is a reliable surrogate marker for human papillomavirus (HPV) causation in oropharyngeal squamous cell carcinoma (OPSCC) and is requested on neck FNA. However, p16 IHC is not validated on cytology cell blocks with no established interpretation guidelines. The current study compared p16 IHC in cytology and surgical specimens, to devise criteria for accurate p16 evaluation in cytology cell blocks to ensure close to 100% specificity of a positive result. p16 IHC was examined in 27 matched FNA and surgical cases of OPSCC over a two-year period. Fifty viable basaloid tumor cells in clusters were considered adequate. Both cytoplasmic and nuclear staining was evaluated. Extent of nuclear p16 staining was scored as <25%, 25%-50%, 50%-75% or >75%; intensity was scored as mild, moderate, or intense. Three of 27 were p16 negative on both the cytology and surgical specimens, and served as negative controls. The remaining 24 cases were p16 positive on the surgical specimens. Eight were excluded due to low cellularity or presence of only desquamated individual keratinized tumor cells. Six of 27 showed >75% cells with weak-intense nuclear staining. Three of 27 showed 50%-75% cells with weak-intense nuclear staining. One of 27 had weak nuclear staining in <25% cells. Three of 27 showed only weak cytoplasmic staining. Three of 27 had no nuclear or cytoplasmic staining. At least 50 viable basaloid cells in small groups should be assessed. Cells with any cytoplasmic staining should be evaluated for nuclear staining. A threshold of 25% nuclear staining results in a specificity of 100%.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".