机构:[1]Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.河北医科大学第四医院[2]AI Lab, Tencent, Shenzhen, Guangdong, China[3]Department of Pathology, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan, China.[4]Department of Pathology, Affiliated Hospital of Hebei University, Baoding, Hebei, China[5]Department of Pathology, Xingtai People’s Hospital/Hebei Medical University Affiliated Hospital, Xingtai, Hebei, China.[6]Department of Pathology, Cangzhou Hospital of Integrated TCM-WM, Cangzhou, Hebei, China
Programmed death ligand-1 (PD-L1) expression is a key biomarker to screen patients for PD-1/PD-L1-targeted immunotherapy. However, a subjective assessment guide on PD-L1 expression of tumor-infiltrating immune cells (IC) scoring is currently adopted in clinical practice with low concordance. Therefore, a repeatable and quantifiable PD-L1 IC scoring method of breast cancer is desirable. In this study, we propose a deep learning-based artificial intelligence-assisted (AI-assisted) model for PD-L1 IC scoring. Three rounds of ring studies (RSs) involving 31 pathologists from 10 hospitals were carried out, using the current guideline in the first two rounds (RS1, RS2) and our AI scoring model in the last round (RS3). A total of 109 PD-L1 (Ventana SP142) immunohistochemistry (IHC) stained images were assessed and the role of the AI-assisted model was evaluated. With the assistance of AI, the scoring concordance across pathologists was boosted to excellent in RS3 (0.950, 95% confidence interval (CI): 0.936-0.962) from moderate in RS1 (0.674, 95% CI: 0.614-0.735) and RS2 (0.736, 95% CI: 0.683-0.789). The 2- and 4-category scoring accuracy were improved by 4.2% (0.959, 95% CI: 0.953-0.964) and 13% (0.815, 95% CI: 0.803-0.827) (p < 0.001). The AI results were generally accepted by pathologists with 61% "fully accepted" and 91% "almost accepted". The proposed AI-assisted method can help pathologists at all levels to improve the PD-L1 assay (SP-142) IC assessment in breast cancer in terms of both accuracy and concordance. The AI tool provides a scheme to standardize the PD-L1 IC scoring in clinical practice.
基金:
This work was supported by the grant from the Beijing Jingjian Foundation for the
Advancement of Pathology (No. 2019–0007)
第一作者机构:[1]Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
共同第一作者:
通讯作者:
推荐引用方式(GB/T 7714):
Wang Xinran,Wang Liang,Bu Hong,et al.How can artificial intelligence models assist PD-L1 expression scoring in breast cancer: results of multi-institutional ring studies.[J].NPJ BREAST CANCER.2021,7(1):doi:10.1038/s41523-021-00268-y.
APA:
Wang Xinran,Wang Liang,Bu Hong,Zhang Ningning,Yue Meng...&Liu Yueping.(2021).How can artificial intelligence models assist PD-L1 expression scoring in breast cancer: results of multi-institutional ring studies..NPJ BREAST CANCER,7,(1)
MLA:
Wang Xinran,et al."How can artificial intelligence models assist PD-L1 expression scoring in breast cancer: results of multi-institutional ring studies.".NPJ BREAST CANCER 7..1(2021)