The advent of immune-checkpoint inhibitors (ICI) in modern oncology has significantly improved survival in several cancer settings. A subgroup of women with breast cancer (BC) has immunogenic infiltration of lymphocytes with expression of programmed death-ligand 1 (PD-L1). These patients may potentially benefit from ICI targeting the programmed death 1 (PD-1)/PD-L1 signaling axis. The use of tumor-infiltrating lymphocytes (TILs) as predictive and prognostic biomarkers has been under intense examination. Emerging data suggest that TILs are associated with response to both cytotoxic treatments and immunotherapy, particularly for patients with triple-negative BC. In this review from The International Immuno-Oncology Biomarker Working Group, we discuss (a) the biological understanding of TILs, (b) their analytical and clinical validity and efforts toward the clinical utility in BC, and (c) the current status of PD-L1 and TIL testing across different continents, including experiences from low-to-middle-income countries, incorporating also the view of a patient advocate. This information will help set the stage for future approaches to optimize the understanding and clinical utilization of TIL analysis in patients with BC.

Objective: to evaluate the quality of the sputum sample before and after the Nursing guidance to patients. Methods: this is a quasi-experimental research design, single group type, before and after, non-randomized study. The study enrolled patients with suspected pulmonary tuberculosis, respiratory symptomatic patients for over three weeks, aged over 18 years, of both genders and without tuberculosis history in the last two years. The educational intervention consisted of individualized guidance on the collection of sputum sample, which was based on the guidelines of the Ministry of Health of Brazil and on the explanatory folder delivery. Results: in this study participated 138 patients with suspected pulmonary tuberculosis. The results showed significant increase of the samples with purulent particles, volume greater than 5 mL and increased rate of patients diagnosed with tuberculosis, after the educational intervention. Conclusion: it was shown that after the educational intervention, it was observed sputum samples with better quality, with satisfactory aspect and volume for the effectiveness of the bacilloscopic examination.

This article presents a systematic analysis of focus functions in conventional sputum smear microscopy for tuberculosis. This is the first step in the development of automatic microscopy. Nine autofocus functions are analyzed in a set of 1200 images with varying degrees of content density. These functions were evaluated using quantitative procedures. The main accomplishment of this work was to show that an autofocus function based on variance measures produced the best results for tuberculosis images.

Tuberculosis (TB) is one of the top 10 causes of death worldwide. The diagnosis and treatment of TB in its early stages is fundamental to reducing the rate of people affected by this disease. In order to assist specialists in the diagnosis in bright field smear images, many studies have been developed for the automatic Mycobacterium tuberculosis detection, the causative agent of Tb. To contribute to this theme, a method to bacilli detection associating convolutional neural network (CNN) and a mosaic-image approach was implemented. The propose was evaluated using a robust image dataset validated by three specialists. Three CNN architectures and 3 optimization methods in each architecture were evaluated. The deeper architecture presented better results, reaching accuracies values above 99%. Other metrics like precision, sensitivity, specificity and F1-score were also used to assess the CNN models performance. Clinical Relevance-The presented works provides an automatic method to aid the diagnosis of tuberculosis in brightfield microscopy.

Introduction: According to the Global TB control report of 2013, "Tuberculosis (TB) remains a major global health problem. In 2012, an estimated 8.6 million people developed TB and 1.3 million died from the disease. Two main sputum smear microscopy techniques are used for TB diagnosis: Fluorescence microscopy and conventional microscopy. Fluorescence microscopy is a more expensive diagnostic method because of the high costs of the microscopy unit and its maintenance. Therefore, conventional microscopy is more appropriate for use in developing countries. Methods: This paper presents a new method for detecting tuberculosis bacillus in conventional sputum smear microscopy. The method consists of two main steps, bacillus segmentation and post-processing. In the fi rst step, the scalar selection technique was used to select input variables for the segmentation classifi ers from four color spaces. Thirty features were used, including the subtractions of the color components of different color spaces. In the post-processing step, three fi lters were used to separate bacilli from artifact: a size fi lter, a geometric fi lter and a Rule-based fi lter that uses the components of the RGB color space. Results: In bacillus identifi cation, an overall sensitivity of 96.80% and an error rate of 3.38% were obtained. An image database with 120-sputum-smear microscopy slices of 12 patients with objects marked as bacillus, agglomerated bacillus and artifact was generated and is now available online. Conclusions: The best results were obtained with a support vector machine in bacillus segmentation associated with the application of the three post-processing fi lters.