Current status and challenges in HER2 IHC assessment: scoring survey results in Japan.

IF 3 3区医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-11-04 DOI:10.1007/s10549-024-07532-2

Takashi Sakatani, Hitoshi Tsuda, Masayuki Yoshida, Naoko Honma, Shinobu Masuda, Tomo Osako, Amiko Hayashi, Ana Richelia Jara-Lazaro, Rie Horii

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Abstract

Purpose: This study aimed to assess the concordance of human epidermal growth factor receptor 2 (HER2) expression scoring by immunohistochemistry (IHC) among practicing pathologists in Japan, given the challenging nature of scoring and the critical role of HER2 status in breast cancer management.

Methods: Whole slide images (WSI) from 20 invasive breast cancer cases (1 representative WSI per case) selected to represent a diverse IHC scores and staining patterns were used in an online survey involving seven reference pathologists who established consensus HER2 IHC scores (0 to 3 +) decided by majority interpretation. Participating pathologists nationwide scored the same 20 WSI cases online using the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) 2018 guidelines. Deidentified case metadata were registered in the uPath system.

Results: A total of 144 participating pathologists responded. The scoring results of the participating pathologists most commonly agreed with the consensus IHC score, followed by a ± 1 point deviation and no survey responses with > 1 point deviation. The mean percentage of agreement with the consensus score for all 20 cases was 63.4%. In cases where the reference pathologists' scores were discordant, the participating pathologists also showed a lower concordance rate.

Conclusion: This study highlighted the current status of HER2 expression scoring by IHC for breast cancer among pathologists in Japan. These findings underscore the challenges in HER2 IHC scoring cases and emphasize the need for improved standardization and training, especially in the evolving landscape of HER2-targeted therapies.

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HER2 IHC 评估的现状与挑战：日本的评分调查结果。

目的：本研究旨在评估日本执业病理学家通过免疫组织化学（IHC）对人表皮生长因子受体2（HER2）表达评分的一致性，因为评分具有挑战性，而且HER2状态在乳腺癌治疗中起着至关重要的作用：方法：从 20 例浸润性乳腺癌病例（每例 1 个代表性病例）中挑选出代表不同 IHC 评分和染色模式的整张切片图像（WSI），进行在线调查，由 7 位参考病理学家根据多数人的解释确定一致的 HER2 IHC 评分（0 至 3 +）。全国参与调查的病理学家采用美国临床肿瘤学会/美国病理学家学会（ASCO/CAP）2018 年指南对相同的 20 个 WSI 病例进行在线评分。在uPath系统中登记了去身份化病例元数据：共有 144 位参与病理学家做出了回应。参与调查的病理学家的评分结果最常见的是与共识IHC评分一致，其次是±1分的偏差，没有偏差>1分的调查回复。所有 20 个病例与共识评分的平均一致率为 63.4%。在参考病理学家评分不一致的病例中，参与调查的病理学家的评分一致率也较低：本研究强调了日本病理学家通过 IHC 对乳腺癌 HER2 表达进行评分的现状。这些发现凸显了 HER2 IHC 评分病例所面临的挑战，强调了加强标准化和培训的必要性，尤其是在 HER2 靶向疗法不断发展的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.