Evaluation of Residual Cellularity and Proliferation on Preoperatively Treated Breast Cancer: A Comparison between Image Analysis and Light Microscopy Analysis

Abstract

Histopathology has been suggested as a reliable method for tumour reduction evaluation of preoperatively treated breast cancer. Immunocytochemistry can be used to enhance the visibility of residual tumour cellularity and in the evaluation of its proliferative activity. We compared Image Analysis (IA) with Light Microscopy Analysis (LMA) on sections of breast carcinomas treated with preoperative chemo‐ or chemo/radiotherapy in the evaluation of the Neoplastic Cell Density (NCD) (69 cases) and the Proliferation Index (PI) (35 cases). NCD was expressed as the immunoreactive area to cytokeratin over the total original neoplastic area and PI was expressed as the number of immunostained tumoural nuclei with MIB1 MoAb over the total of tumoural nuclei. The intraobserver agreement and that between IA and LMA for both indices were estimated by the common (Kw) and the jackknife weighted kappa statistic (trueK~w). The extent of agreement of each considered category was also assessed by means of the category‐specific kappa statistics (Kcs). The intraobserver agreement within LMA for NCD and PI and that between IA and LMA for PI were both satisfactory. Upon evaluation of the NCD, the agreement between IA and LMA showed unsatisfactory results, especially when the ratio between the residual tumour cells and the background was critical.

External Quality Assessment (EQA) program for the preanalytical and analytical immunohistochemical determination of HER2 in breast cancer: an experience on a regional scale

“…In addition, in order to evaluate the contribution of each scoring category to the overall agreement (i.e. the agreement between the score given by the reviewers on the slides stained by each laboratory in accordance with the reference values) the kappa category-specific (k cs ) statistic [19], and its 95% confidence interval obtained by means of the Jackknife method [20], were calculated as previously described [21,22]. To this end, the slides stained by all the participants were jointly considered.…”

Evaluation of colon cancer histomorphology: a comparison between formalin and PAXgene tissue fixation by an international ring trial

“…For the reproducibility between fixation methods as well as between reference evaluation and fixation method, all the participants' data were used to compute the modal category within each method for each case (modal scenario (MS)). Then, by starting from these modal values, the jackknifed estimate of the weighted kappa statistic (k wj ) was computed together with the relative 95 % confidence interval (CI) [7]. In addition, for the inter-observer reproducibility the kappa category-specific statistics (k cs ) and their weighted averages (Cohen's kappa statistic (k c )) were estimated by jointly considering all participants data [9,13].…”