Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer

Aim: Tumor-infiltrating lymphocytes (TILs) have a prognostic value in breast cancer (BC); however, because of the lack of standard evaluation methods, we aimed to assess the interobserver agreement of stromal TILs (sTILs) and intratumoral TILs (iTILs) as well as the effect of hot spot areas and mole...

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Main Authors: Fatmagul Kusku Cabuk, Fatma Aktepe, Fatma Nilgun Kapucuoglu, Ipek Coban, Dauren Sarsenov, Vahit Ozmen
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Indian Journal of Pathology and Microbiology
Subjects:
Online Access:http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=2;spage=181;epage=186;aulast=Cabuk
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author Fatmagul Kusku Cabuk
Fatma Aktepe
Fatma Nilgun Kapucuoglu
Ipek Coban
Dauren Sarsenov
Vahit Ozmen
author_facet Fatmagul Kusku Cabuk
Fatma Aktepe
Fatma Nilgun Kapucuoglu
Ipek Coban
Dauren Sarsenov
Vahit Ozmen
author_sort Fatmagul Kusku Cabuk
collection DOAJ
description Aim: Tumor-infiltrating lymphocytes (TILs) have a prognostic value in breast cancer (BC); however, because of the lack of standard evaluation methods, we aimed to assess the interobserver agreement of stromal TILs (sTILs) and intratumoral TILs (iTILs) as well as the effect of hot spot areas and molecular subtyping on the overall agreement. Methods: The study consisted of 121 haematoxylin and eosin (H and E)-stained slides of invasive BC samples obtained from the pathology archives. The TIL assessment was based on the International TIL Working Group recommendations for the percentage of sTILs and was conducted by four pathologists. The percentage of iTILs, the number of lymphocytes in hot spot areas (iTILs-HS), and the overall interobserver agreement for the molecular subtypes were evaluated. The interclass correlation coefficient (ICC) was used to assess interobserver agreement among the four pathologists. Results: The ICC score among the observers for the sTIL percentages was 0.74, and the individual ICC values for each molecular subtype were 0.55, 0.88, and 0.79 for luminal, HER2-positive, and triple-negative tumors, respectively. The compliance value for the iTILs was 0.29 (95% confidence interval (CI) = 0.06–0.48], whereas the compliance value for the iTILs-HS was 0.63 (95% CI = 0.49–0.71). The compliance values for the iTILs-HS subtypes were 0.72, 0.43, and 0.55 for luminal, HER2-positive, and triple-negative tumors, respectively. Conclusion: The IWTILG recommendations are reproducible and reliable. The interobserver agreement of the sTIL percentages was considerably higher for the triple-negative and HER2-positive cases than the luminal cases, whereas the interobserver agreement for the assessment of iTILs-HS in tumors was higher for the luminal subtype.
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spelling doaj.art-afa2b01c01d649eaafbf04c5dece12c32022-12-21T22:22:08ZengWolters Kluwer Medknow PublicationsIndian Journal of Pathology and Microbiology0377-49292018-01-0161218118610.4103/IJPM.IJPM_131_17Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancerFatmagul Kusku CabukFatma AktepeFatma Nilgun KapucuogluIpek CobanDauren SarsenovVahit OzmenAim: Tumor-infiltrating lymphocytes (TILs) have a prognostic value in breast cancer (BC); however, because of the lack of standard evaluation methods, we aimed to assess the interobserver agreement of stromal TILs (sTILs) and intratumoral TILs (iTILs) as well as the effect of hot spot areas and molecular subtyping on the overall agreement. Methods: The study consisted of 121 haematoxylin and eosin (H and E)-stained slides of invasive BC samples obtained from the pathology archives. The TIL assessment was based on the International TIL Working Group recommendations for the percentage of sTILs and was conducted by four pathologists. The percentage of iTILs, the number of lymphocytes in hot spot areas (iTILs-HS), and the overall interobserver agreement for the molecular subtypes were evaluated. The interclass correlation coefficient (ICC) was used to assess interobserver agreement among the four pathologists. Results: The ICC score among the observers for the sTIL percentages was 0.74, and the individual ICC values for each molecular subtype were 0.55, 0.88, and 0.79 for luminal, HER2-positive, and triple-negative tumors, respectively. The compliance value for the iTILs was 0.29 (95% confidence interval (CI) = 0.06–0.48], whereas the compliance value for the iTILs-HS was 0.63 (95% CI = 0.49–0.71). The compliance values for the iTILs-HS subtypes were 0.72, 0.43, and 0.55 for luminal, HER2-positive, and triple-negative tumors, respectively. Conclusion: The IWTILG recommendations are reproducible and reliable. The interobserver agreement of the sTIL percentages was considerably higher for the triple-negative and HER2-positive cases than the luminal cases, whereas the interobserver agreement for the assessment of iTILs-HS in tumors was higher for the luminal subtype.http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=2;spage=181;epage=186;aulast=CabukBreast cancerbreast pathologytumor immunitytumor-infiltrating lymphocyte
spellingShingle Fatmagul Kusku Cabuk
Fatma Aktepe
Fatma Nilgun Kapucuoglu
Ipek Coban
Dauren Sarsenov
Vahit Ozmen
Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
Indian Journal of Pathology and Microbiology
Breast cancer
breast pathology
tumor immunity
tumor-infiltrating lymphocyte
title Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
title_full Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
title_fullStr Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
title_full_unstemmed Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
title_short Interobserver reproducibility of tumor-infiltrating lymphocyte evaluations in breast cancer
title_sort interobserver reproducibility of tumor infiltrating lymphocyte evaluations in breast cancer
topic Breast cancer
breast pathology
tumor immunity
tumor-infiltrating lymphocyte
url http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=2;spage=181;epage=186;aulast=Cabuk
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AT fatmanilgunkapucuoglu interobserverreproducibilityoftumorinfiltratinglymphocyteevaluationsinbreastcancer
AT ipekcoban interobserverreproducibilityoftumorinfiltratinglymphocyteevaluationsinbreastcancer
AT daurensarsenov interobserverreproducibilityoftumorinfiltratinglymphocyteevaluationsinbreastcancer
AT vahitozmen interobserverreproducibilityoftumorinfiltratinglymphocyteevaluationsinbreastcancer