Annals of Diagnostic Pathology最新文献

{"title":"Evaluation of whole-slide imaging for diagnosing frozen sections","authors":"Muhammad Ahsan ,&nbsp;Fizza Jahangir ,&nbsp;Saira Rathore ,&nbsp;Mahrukh Mumtaz ,&nbsp;Samina Zaman","doi":"10.1016/j.anndiagpath.2024.152431","DOIUrl":"10.1016/j.anndiagpath.2024.152431","url":null,"abstract":"<div><div>A promising application of digital pathology is the use of Whole slide imaging (WSI) for rapid and remote intraoperative consultations. Based on recommendations from the College of American Pathologists, we compared diagnostic accuracy and technical analysis of WSI with optical microscopy (OM) for reporting frozen sections (FS). A series of 105 consecutive FS cases were included in our study and were categorized as primary diagnosis, assessment of margin status, and lymph node status. A surgical pathologist reviewed all WSI digital slides of FS cases online and their corresponding glass slides using OM after a 2-week washout period. Technical and diagnostic parameters for remote reporting of frozen sections using WSI were compared to routine OM. Diagnostic agreement between WSI and OM in the FS cases was 100 %. In comparison with the reference standard (original sign-out diagnosis), the overall diagnostic accuracy of WSI and OM was 99.04 %. Scan time per slide averaged 103.89 s. Mean diagnostic assessment time for OM was 17.48 s, while it was 26.62 s for WSI, with a mean difference of 9.14 s (<em>P</em> &lt; .001). The overall mean turnaround time was 3.8 min for reporting a single slide using WSI based digital pathology system. The diagnostic accuracy of WSI is comparable to that of conventional OM. Therefore, we conclude that WSI based digital pathology systems can be safely implemented and integrated into a laboratory workflow as an alternative to conventional OM.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152431"},"PeriodicalIF":1.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass-forming isolated ischemic necrosis of the cecum mimicking malignancy: Clinicopathologic features of 11 cases","authors":"Xiaoyan Liao ,&nbsp;Douglas K. Rex ,&nbsp;Dongwei Zhang","doi":"10.1016/j.anndiagpath.2024.152428","DOIUrl":"10.1016/j.anndiagpath.2024.152428","url":null,"abstract":"<div><div>Isolated ischemic necrosis of the cecum (INC) is an uncommon benign condition that occurs most often in elderly patients. The clinical presentation and radiographic findings often mimic acute appendicitis or malignancy. This study aimed to investigate the clinicopathologic features of mass-forming INC. Eleven INC patients who presented with cecal masses were identified by searching the electronic medical record system in two large academic centers. The clinical and pathological features, including symptoms, imaging, endoscopic and surgical findings, histomorphology, and follow-up, were retrospectively analyzed. The study cohort included 4 males and 7 females, with a median age 72 (range 43–87) years. Common clinical presentations included right lower quadrant abdominal pain, nausea and vomiting, and bloody diarrhea. Nine patients had hypertension and cardiovascular diseases, including coronary artery disease, congestive heart failure, atrial fibrillation, and heart valve disease. All patients had a mass in the cecum by endoscopy and/or imaging studies, clinically suspicious for malignancy. The median mass size was 5 (range 3.1–6) cm. Six patients received non-surgical treatment after the biopsy specimen proved a benign histologic pattern of ischemic necrosis. The remaining 5 patients underwent right hemicolectomy. Pathologic examination of the biopsy or resection specimens showed similar histologic changes such as mucosal denudation, ulceration, necrosis, crypt withering and loss, and lamina propria hyalinization, findings consistent with ischemic necrosis. No malignancy was identified in any case. After a median follow-up of 78 (range 3–121) months, 10 patients were still alive. Only 1 patient died and this was from other causes and 96 months later. Mass-forming INC is a rare and unique variant of ischemic colitis that occurs in elderly patients with a low flow state. It is a benign condition with a favorable prognosis. INC should be considered in patients with long-standing hypertension or cardiovascular disease who present with right lower quadrant abdominal pain and cecal mass. Biopsy of the mass with pathologic examination helps make a diagnosis, assess the disease severity, and rule out malignancy. Awareness of this rare entity is important to avoid unnecessary resections in these patients.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152428"},"PeriodicalIF":1.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of large cribriform carcinoma and “unfavorable histology” with other Gleason pattern 4 subtypes: A proof-of-principle study evaluating 485 radical prostatectomy specimens with proposal for the concept of “borderline histology”","authors":"Jane K. Nguyen ,&nbsp;Jianbo Li ,&nbsp;Chien-Kuang C. Ding ,&nbsp;Christopher J. Weight ,&nbsp;Jesse K. McKenney","doi":"10.1016/j.anndiagpath.2024.152427","DOIUrl":"10.1016/j.anndiagpath.2024.152427","url":null,"abstract":"<div><div>Prostatic adenocarcinomas with large cribriform glands/intraductal carcinoma (LC/IDC), or the recently proposed unfavorable histology, are associated with adverse outcomes after radical prostatectomy. However, Gleason pattern 4 carcinomas without LC/IDC (or unfavorable histology) have minimal risk for aggressive clinical behavior after prostatectomy. As proof-of-principle study, we collected a cohort of 485 radical prostatectomy specimens to assess correlations between different subtypes of Gleason pattern 4 disease and the presence of adjacent high-risk prostatic adenocarcinoma, defined as LC/IDC or unfavorable histology. All prostatectomies were completely embedded, and all slides re-reviewed to record Gleason score/Grade Group, diameter of the largest cribriform gland (i.e. the longest cross-sectional distance), and all architectural patterns of carcinoma utilizing previously described Canary methodology. The presence and percent of LC/IDC (defined as &gt;0.25 mm) was determined. We also evaluated correlation with the recently proposed “unfavorable histology” as a secondary endpoint. Complex Gleason pattern 4 subtypes, distinct from LC/IDC and unfavorable histology, were termed “borderline histology” and defined as the presence of any of the following patterns: small cribriform/glomeruloid architecture (≤0.25 mm), dominant population of poorly formed glands/small nests, simple glomerulations, and epithelial complexity associated with extravasated mucin (beyond typical mucinous fibroplasia pattern and not containing cribriform &gt;0.25 mm). Comparisons between recorded variables and LC/IDC (or unfavorable histology) utilized the Wilcoxon test for continuous variables and chi-squared test or Fisher's test for categorical variables. Pearson or phi correlation coefficients were used to assess the association between two variables. “Borderline histology” was significantly correlated to LC/IDC (r = 0.55) and unfavorable histology (r = 0.607), both p &lt; 0.001. Specifically, small cribriform/small glomeruloid architecture had the strongest correlation, compared to the other “borderline histology” subtypes (r = 0.646). We demonstrate that “borderline histology” has a strong association with the concomitant presence of high-risk prostate cancer by current histologic definitions (i.e. LC/IDC and unfavorable histology). This proof-of-principle study suggests that large cohort biopsy-RP correlation studies are needed, as the presence of these patterns on biopsy could potentially aid preoperative risk stratification for patients without other high-risk features at initial evaluation.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152427"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the swirl sign: A radiologic-pathologic correlation in deep angiomyxoma","authors":"Hiroshi Yoshida ,&nbsp;Nao Kikkawa ,&nbsp;Waku Takigawa ,&nbsp;Masaya Uno ,&nbsp;Mitsuya Ishikawa","doi":"10.1016/j.anndiagpath.2024.152426","DOIUrl":"10.1016/j.anndiagpath.2024.152426","url":null,"abstract":"<div><div>Deep angiomyxoma (DA) is a rare, slow-growing soft tissue tumor typically affecting women of reproductive age. Despite its benign histology, it poses significant clinical challenges due to local invasiveness and high recurrence. Accurate diagnosis through radiologic imaging, particularly MRI, is essential for guiding treatment. One key imaging feature of DA is the “swirl sign,” a distinctive pattern on T2-weighted images. However, its histological basis remains unclear. Here, we present a case of DA in a 46-year-old woman, highlighting the correlation between radiologic and histopathologic findings. MRI showed the characteristic swirl sign, which histologically corresponded to straight-running blood vessels aligned with the tumor's long axis, supported by collagen fibers within an edematous stroma. This case offers novel insight into the origins of the swirl sign and provides research questions on this sign. Further research is needed to explore its potential as a biomarker for tumor growth and aggressiveness.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152426"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal Rhinosinusitis: An integrated diagnostic approach","authors":"R Soundarya ,&nbsp;H.C Deepa ,&nbsp;Peralam Yegneswaran Prakash ,&nbsp;V Geetha","doi":"10.1016/j.anndiagpath.2024.152415","DOIUrl":"10.1016/j.anndiagpath.2024.152415","url":null,"abstract":"<div><div>Classification of fungal rhinosinusitis (FRS) based on histomorphology and clinical presentation aids in early diagnosis and prompt patient management. In this retrospective observational study, clinicopathologic findings in patients diagnosed with fungal rhinosinusitis between January 2019 and December 2021 were evaluated. Clinical and imaging findings were retrieved from hospital records; slides from routine and histochemical studies were reviewed, and the cases were classified into non-invasive [fungal ball (FB) and allergic fungal rhinosinusitis (AFRS)] and invasive FRS [acute invasive fungal rhinosinusitis (AIFRS), chronic invasive fungal rhinosinusitis (CIFRS) and chronic invasive granulomatous fungal rhinosinusitis (CGFRS)]. Fungal cultures were also compared with histopathology. Of the 85 patients in the study, 34% were non-invasive (86% FB,10% AFRS, and 4% unclassified), and 66% were invasive (70% AIFRS, 21% CGFRS, and 9% CIFRS). The mean age of patients was 51 years, with a male-to-female ratio of 1.5:1. The most common comorbidity was diabetes with COVID-19 co-infection. Culture reports were available for 77 patients, of which 36 cases had growth, the majority of which were Aspergillus; 7 patients had coinfection with Aspergillus and Mucorales. Comparing histopathology to the gold standard mycology for Aspergillus, a sensitivity of 90%, specificity of 96%, and Cohen's Kappa of 0.8 was achieved. This study emphasizes the value of an integrated diagnostic approach in arriving at an appropriate diagnosis. In resource-limited settings, histopathological evaluation can be a valuable screening tool, aiding in early diagnosis.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152415"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Castleman disease-type histopathological patterns of lymph nodes in patients with plasma cell neoplasia and POEMS syndrome","authors":"Laura Rodriguez-Merino,&nbsp;Santiago Montes-Moreno","doi":"10.1016/j.anndiagpath.2024.152414","DOIUrl":"10.1016/j.anndiagpath.2024.152414","url":null,"abstract":"<div><div>Plasma cell neoplasia and POEMS syndrome patients may present Castleman disease (CD)-type features in lymph nodes. Our aim was to better characterize the histopathological patterns found in plasma cell neoplasia associated CD and to improve the detection of clonal plasma cell populations in the lymph node biopsies of these patients.</div><div>Lymph node and bone marrow samples from six cases with plasma cell neoplasia associated CD, including POEMS syndrome and multiple myeloma were analyzed. A complete analysis including morphology, IHC and PCR-based clonality detection in the lymph node biopsies and morphology; IHC and FCM in the bone marrow biopsies was done. Correlation with clinical and laboratory features was performed.</div><div>Both plasma cell rich and hyper vascular Castleman disease like histopathological features were found. In two out of six cases, sheets of plasma cells with light chain and isotype restriction were identified in the lymph nodes. B cell clonality analysis provided evidence of clonal populations in 5 out of 6 cases, increasing the sensitivity for the detection in cases without morphologically identifiable monotypic plasma cells. None of the twelve control cases with iMCD and HHV-8 positive CD showed clonal populations.</div><div>In conclusion, the combination of morphology, complete immunophenotyping and B cell clonality analysis in the lymph node biopsy may provide evidence of clonal populations in up to 83 % of cases with plasma cell neoplasia/POEMS syndrome associated Castleman disease. Clinical work-up for the confirmation of plasma cell dyscrasia is advisable in such cases.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"74 ","pages":"Article 152414"},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology of rheumatoid meningitis: A report of 5 cases highlighting the importance of clinical correlation","authors":"Samuel Guzman ,&nbsp;B.K. Kleinschmidt-DeMasters","doi":"10.1016/j.anndiagpath.2024.152412","DOIUrl":"10.1016/j.anndiagpath.2024.152412","url":null,"abstract":"<div><div>Rheumatoid meningitis (RM) presents with sufficiently wide-ranging, but non-specific, symptoms and neuroimaging features of pachy- and/or leptomeningeal thickening that it may be indistinguishable from subacute infectious meningitis. RA diagnosis variably antedates RM and serological confirmation by rheumatoid factor and anti-citrullinated peptide antibodies may not be present preoperatively. Thus, meningeal biopsy may be undertaken. Classic examples of RM show lymphoplasmacytic leptomeningeal inflammation and small vessel vasculitis, with rheumatoid nodules being less frequent. We reviewed our experience with 5 RM biopsies, as well as the literature, placing “classic” histological findings in perspective with biopsies showing less pathognomonic features. 5 RM cases were identified, 2 male: 3 female, ages 62–79 years. All patients had leptomeningeal enhancement by MRI and 2 had known negative RF serology prior to meningeal biopsy. In 1 case RF was initially negative, but on serological reassessment turned positive; 2 patients were diagnosed by clinical correlation. 4 leptomeningeal/superficial cortical biopsies manifested chronic lymphoplasmacytic inflammation with multinucleated giant cells, with discrete foci of deep blue/black necrosis with cellular debris (“dirty necrosis”) surrounded by a variably- developed palisade of histiocytes (rheumatoid nodules). The 5th showed only non-specific mononuclear cell inflammation. All showed variable degrees of diffuse astrocytosis and microgliosis of the cortex without microglial clusters or compact granulomas. Stains for microorganisms were negative. Diagnosis of RM can be suspected by the pathologist if the “classic” features of rheumatoid nodules are present on biopsy, but in some cases, only non-specific inflammation is present. Diagnosis necessitates correlation between clinical, serological, and histological features.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"74 ","pages":"Article 152412"},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does H3K27me3 expression play a role in patients with Blastic plasmacytoid dendritic cell neoplasm? A clinicopathologic analysis of 14 patients","authors":"Kuai Yu ,&nbsp;Gang Meng ,&nbsp;Hong He ,&nbsp;Wenwen Li ,&nbsp;Lixin Wang ,&nbsp;Yuanxin Li ,&nbsp;Xingyu Wang ,&nbsp;Ying Huang ,&nbsp;Juan He ,&nbsp;Min Zhao ,&nbsp;Tao Xie ,&nbsp;Zeng Zhen ,&nbsp;Dan Li","doi":"10.1016/j.anndiagpath.2024.152413","DOIUrl":"10.1016/j.anndiagpath.2024.152413","url":null,"abstract":"<div><div>Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive lymphohematopoietic malignancy associated with poor prognosis. We aimed to improve the understanding of BPDCN, explore its prognostic significance, and identify potential therapeutic targets. Data from 14 BPDCN patients were retrospectively collected and analyzed, focusing on their clinicopathological characteristics, diagnostic features, immunophenotype, treatment regimens, and prognostic factors. Additionally, immunohistochemistry was used to detect the expression of multiple oncogenes in BPDCN. The cohort comprised 14 patients (10 males, 4 females) with a median age of 63.5 years at the time of diagnosis. Of these specimens, H3K27me3, ASXL1, BAP1, RAC1, TCF4 and AURKA were highly expressed in BPDCN, with expression rates of 71.4 % (10/14), 92.9 % (13/14), 85.7 % (12/14), 100 % (13/13), 12/14 (85.7 %) and 46.2 % (6/13), respectively. The survival of patients in this cohort ranged from 1 to 84 months, with a median overall survival (OS) of 18.5 months. The survival rates for 1, 2, 3, 4 and 5 years were 71.43 %, 53.57 %, 44.64 %, 44.64 %, and 44.64 %, respectively. In the overall BPDCN cohort, patients with positive expression of H3K27me3 exhibited significantly better overall survival compared to those with negative expression H3K27me3 (<em>P</em> = 0.0056). Our analysis showed that the absence of H3K27me3 expression may indicate a poor prognosis in patients with BPDCN, and H3K27me3 may be a potential prognostic indicator for BPDCN.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"74 ","pages":"Article 152413"},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the recently established Dutch nationwide Archipelago of Ovarian Cancer Research biobank","authors":"Hein S. Zelisse ,&nbsp;Mignon D.J.M. van Gent ,&nbsp;Constantijne H. Mom ,&nbsp;Sander de Ridder ,&nbsp;Malou L.H. Snijders ,&nbsp;Marlou Heeling ,&nbsp;Matthijs Stoter ,&nbsp;Annegien Broeks ,&nbsp;Hugo M. Horlings ,&nbsp;Christianne A.R. Lok ,&nbsp;Steven L. Bosch ,&nbsp;Jurgen M. Piek ,&nbsp;Joost Bart ,&nbsp;Anna K.L. Reyners ,&nbsp;G. Bea A. Wisman ,&nbsp;Refika Yigit ,&nbsp;Ingrid A. Boere ,&nbsp;Margriet Collée ,&nbsp;Floris H. Groenendijk ,&nbsp;Maurice P.H.M. Jansen ,&nbsp;Frederike Dijk","doi":"10.1016/j.anndiagpath.2024.152411","DOIUrl":"10.1016/j.anndiagpath.2024.152411","url":null,"abstract":"<div><div>Fundamental and translational research in ovarian cancer aims to enhance understanding of disease mechanisms and improve treatment and survival outcomes. To support this, we established the Dutch multicenter, interdisciplinary Archipelago of Ovarian Cancer Research (AOCR) infrastructure, which includes a nationwide biobank. In this study, we share our experiences in establishing the infrastructure, offer guidance for similar initiatives, and evaluate the AOCR patient cohort. Key challenges included obtaining Data Protection Impact Assessment (DPIA) clearance, drafting the consortium agreement, and securing ethical approval from all hospitals. Over three years, 1093 patients were enrolled across 17 hospitals, resulting in the collection of 1339 tissue samples and 2280 blood samples. Of the 523 patients with currently available clinical and pathological data, 74 % (<em>n</em> = 387) had primary ovarian cancer. Among these patients, 73.4 % was diagnosed with high-grade serous ovarian carcinoma, and 80.9 % presented with advanced-stage disease. Surgery was performed on 93 % of patients with primary ovarian cancer, and chemotherapy was administered to 90.4 % of these patients. In conclusion, the AOCR biobank has established a robust foundation for future fundamental and translational ovarian cancer research. This manuscript provides valuable insights and guidance for developing future research infrastructures and biobanks, and contains detailed information about the AOCR patient cohort to date.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"74 ","pages":"Article 152411"},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence score-predicted value derived from estrogen receptor, tumor-infiltrating lymphocytes, progesterone receptor, and Ki-67 may substitute for the Oncotype DX recurrence score in estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)− breast cancer","authors":"Keiichi Sotome ,&nbsp;Hinako Maeda ,&nbsp;Takako Yanagisawa ,&nbsp;Yuko Harada ,&nbsp;Yuuki Mae ,&nbsp;Masashi Ogiso ,&nbsp;Hiroyuki Sako ,&nbsp;Nobushige Yabe ,&nbsp;Hisashi Yanaihara ,&nbsp;Noriki Kamiya ,&nbsp;Yoshiyuki Ishii ,&nbsp;Akiyoshi Hoshino ,&nbsp;Ichiro Maeda ,&nbsp;Akihiko Suto ,&nbsp;Masahiko Watanabe ,&nbsp;Tadashi Ikeda","doi":"10.1016/j.anndiagpath.2024.152410","DOIUrl":"10.1016/j.anndiagpath.2024.152410","url":null,"abstract":"<div><div>Oncotype DX is the only multigene assay supported by the <span>National Comprehensive Cancer Network</span> (USA) with Level 1 evidence for use on node-negative and postmenopausal node-positive patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (<span><span>HER2</span></span>)-breast cancer to predict the prognosis and to estimate chemotherapy add-on effects. However, the test's high cost prevents its use in most cases. Therefore, we aimed to obtain an alternative recurrence score (RS) prediction formula using the optimal clinicopathological factors. We retrospectively reviewed data of 81 patients with ER+/HER2− primary breast cancer in our hospital where Oncotype DX RS was measured. Stepwise multivariate linear regression analysis was conducted with several selected clinicopathological factors of 60 consecutive cases in the training group. The obtained RS-predicted values were validated against Oncotype DX RS using 21 additional consecutive cases. The RS prediction formula derived from the combination of ER, tumor-infiltrating lymphocytes (TILs), progesterone receptor (PgR), and Ki-67-labeling index produced a favorable model with a correlation coefficient (r) of 0.731103 for the Oncotype DX RS (<em>p</em> = 0.0002) and an adjusted R² coefficient of 0.510013. The RS-predicted values and the actual Oncotype DX RS were classified into four 2 × 2 groups, by using an RS of 26 as a threshold for adding chemotherapy with a concordance rate of 95.2 % (20/21) and a kappa coefficient of 0.829. RS-predicted values of combined ER, TILs, PgR, and Ki-67 may be an appropriate substitute for Oncotype DX RS in certain situations.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"74 ","pages":"Article 152410"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}