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Caramelo A, Polónia A, Vale J, Curado M, Campelos S, Nascimento V, Barros M, Ferreira D, Pereira T, Neves B, Eloy C. Demonstrating the interference of tissue processing in the evaluation of tissue biomarkers: The case of PD-L1. Pathol Res Pract 2023; 248:154605. [PMID: 37320863 DOI: 10.1016/j.prp.2023.154605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
The immunohistochemical (IHC) expression of PD-L1 in cancer models is used as a predictive biomarker of response to immunotherapy. We aimed to evaluate the impact of the usage of 3 different tissue processors in the IHC expression of PD-L1 antibody clones: 22C3 and SP142. Three different topographies of samples (n = 73) were selected at the macroscopy room: 39 uterine leiomyomas, 17 placentas and 17 palatine tonsils. Three fragments were collected from each sample and were inked with a specific color that represented their separate processing in a different tissue processor (A, B or C). During embedding, the 3 fragments with distinct processing were ensemble in the same cassette for sectioning of 3 slides/each: hematoxylin-eosin, 22C3 PDL1 IHC staining and SP142 PD-L1 IHC staining, that were blindly observed by 2 pathologists under digital environment. All but one set of 3 fragments were considered adequate for observation even in the presence of artifacts associated with processing issues that were recorded as high as 50.7 % for processor C. The occurrence of background non-specific staining and the presence of false positive results appear to be unrelated with the PD-L1 clone or the type of tissue processing. 22C3 PD-L1 was more frequently considered adequate for evaluation than SP142 PD-L1 that, in 29.2 % of WSIs (after tissue processor C) were considered not adequate for observation due to lack of the typical pattern of expression. Similarly, the intensity of PD-L1 staining was significantly decreased in fragments processed by C (both PD-L1 clones) in tonsil and placenta specimens, and by A (both clones) in comparison with those processed by B. This study demonstrates the need to standardize the tissue processing in pathology to cope with the growing needs of precision medicine quantifications and the production of high-quality material necessary for computational pathology usage.
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Affiliation(s)
- Ana Caramelo
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - António Polónia
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal
| | - João Vale
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Mónica Curado
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Sofia Campelos
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Vanessa Nascimento
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Mariana Barros
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Diana Ferreira
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Tânia Pereira
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Beatriz Neves
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal
| | - Catarina Eloy
- Pathology Laboratory, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal; Faculty of Medicine of University of Porto (FMUP), Porto, Portugal.
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Campelos S, Polónia A, Caramelo A, Curado M, Eloy C. p40/PD-L1 and TTF1/PD-L1 Immunohistochemical Double Staining Contributes to Intraindividual Variability Associated With PD-L1 Staining Interpretation in Lung Cancer Samples. Appl Immunohistochem Mol Morphol 2022; 30:165-170. [PMID: 35262521 DOI: 10.1097/pai.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 11/08/2021] [Indexed: 12/24/2022]
Abstract
The important developments achieved in recent years with a consequent paradigm shift in the treatment of non-small cell lung cancer (NSCLC), including the latest immune checkpoint inhibitors, have led to an increasing need to optimize the scarce material usually available in the diagnosis of these tumors. In this sense, this study intends to evaluate the performance of double immunohistochemistry (IHC) in comparison to simple IHC for programmed death-ligand 1 (PD-L1) evaluation with 22C3 clone for selection to therapy with pembrolizumab. For that, 38 histologic samples of NSCLC small biopsies sent to our laboratory were selected. Double IHC were performed with the doublets TTF1/PD-L1 and p40/PD-L1, after all the usual diagnostic routine and molecular study was performed. The slides were interpreted by 2 independent pathologists and the results obtained were compared with each other and with the results obtained at diagnosis. A perfect agreement was observed when comparing the immunoexpression of TTF1 and p40 in double IHC in relation to single IHC. Although the agreement was substantial in the analysis of the positive/negative PD-L1 IHC (81.6% to 92.1%; κ=0.610 to 0.829) and in the analysis of the 50% cut-off (86.8% to 89.5%; κ=0.704 to 0.759), it fell short of the expected and desirable agreement for a biomarker such as PD-L1, since this result will have a major role in the institution of a treatment. In conclusion, this small series does not allow us to recommend this methodology for the evaluation of the PD-L1 biomarker in double staining IHC with the 22C3 clone for therapy selection.
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Affiliation(s)
- Sofia Campelos
- Laboratory of Pathology, Ipatimup-Institute of Molecular Pathology and Immunology of University of Porto
- Institute for Research and Innovation in Health, University of Porto
| | - António Polónia
- Laboratory of Pathology, Ipatimup-Institute of Molecular Pathology and Immunology of University of Porto
- Institute for Research and Innovation in Health, University of Porto
| | - Ana Caramelo
- Laboratory of Pathology, Ipatimup-Institute of Molecular Pathology and Immunology of University of Porto
- Institute for Research and Innovation in Health, University of Porto
| | - Mónica Curado
- Laboratory of Pathology, Ipatimup-Institute of Molecular Pathology and Immunology of University of Porto
- Institute for Research and Innovation in Health, University of Porto
| | - Catarina Eloy
- Laboratory of Pathology, Ipatimup-Institute of Molecular Pathology and Immunology of University of Porto
- Institute for Research and Innovation in Health, University of Porto
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
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Polónia A, Canelas C, Caramelo A. The spectrum of HER2 expression in breast cancer: linking immunohistochemistry quantification with in situ hybridization assay. Virchows Arch 2022; 480:1171-1179. [PMID: 35137279 DOI: 10.1007/s00428-022-03290-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/06/2022] [Accepted: 01/29/2022] [Indexed: 12/25/2022]
Abstract
We aimed to document the pathological characteristics of breast cancer (BC) cases with different scores of HER2 by immunohistochemistry (IHC), as well as to establish a relationship between HER2 expression and HER2 amplification by in situ hybridization (ISH). A cohort of 258 primary BC cases was evaluated for HER2 gene amplification with bright-field ISH. All HER2-negative and HER2-positive cases by IHC were concordant with the ISH classification. BC cases with score of 0 had lower average of HER2 copy number compared to cases with score of 1 + . HER2-equivocal cases by IHC had intermediate pathological characteristics between HER2-negative and HER2-positive cases. About 12% of HER2-equivocal cases were classified as ISH-positive. HER2-equivocal cases with HER2 gene amplification had proliferation index, HER2/CEP17 ratio, and average of HER2 copy number between HER2-equivocal cases without HER2 gene amplification and HER2-positive cases by IHC. Additionally, HER2-equivocal cases with HER2 amplification had score of 2 + in at least 50% of the total tumor area, with a proportion of ISH-positive cases increasing with the amount of score of 2 + present in the tumor. The quantification of score of 2 + in the tumor predicted the ISH classification with an AUC of 0.902. A logistic regression model using the same HER2 quantification and the nuclear score was able to increase the abovementioned prediction to an AUC of 0.929. As such, we were able to link HER2 quantification by IHC and morphological analysis with HER2 amplification by ISH.
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Affiliation(s)
- António Polónia
- Department of Pathology, Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology, University of Porto, Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal. .,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
| | - Carolina Canelas
- Department of Pathology, Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology, University of Porto, Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - Ana Caramelo
- Department of Pathology, Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology, University of Porto, Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
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Eloy C, Vale J, Curado M, Polónia A, Campelos S, Caramelo A, Sousa R, Sobrinho-Simões M. Digital Pathology Workflow Implementation at IPATIMUP. Diagnostics (Basel) 2021; 11:diagnostics11112111. [PMID: 34829458 PMCID: PMC8620597 DOI: 10.3390/diagnostics11112111] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/29/2022] Open
Abstract
The advantages of the digital methodology are well known. In this paper, we provide a detailed description of the process for the digital transformation of the pathology laboratory at IPATIMUP, the major modifications that operate throughout the processing pipeline, and the advantages of its implementation. The model of digital workflow implementation at IPATIMUP demonstrates that careful planning and adoption of simple measures related to time, space, and sample management can be adopted by any pathology laboratory to achieve higher quality and easy digital transformation.
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Affiliation(s)
- Catarina Eloy
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
- i3S—Instituto de Investigação e Inovação em Saúde & Pathology Department of Medical Faculty, University of Porto, 4200-135 Porto, Portugal
- Correspondence:
| | - João Vale
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
| | - Mónica Curado
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
| | - António Polónia
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
- i3S—Instituto de Investigação e Inovação em Saúde & Pathology Department of Medical Faculty, University of Porto, 4200-135 Porto, Portugal
| | - Sofia Campelos
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
| | - Ana Caramelo
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
| | - Rui Sousa
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
| | - Manuel Sobrinho-Simões
- Pathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal; (J.V.); (M.C.); (A.P.); (S.C.); (A.C.); (R.S.); (M.S.-S.)
- i3S—Instituto de Investigação e Inovação em Saúde & Pathology Department of Medical Faculty, University of Porto, 4200-135 Porto, Portugal
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Peixoto S, Almeida A, Caramelo A, Mendes L. [Application of the 2015 Beers Criteria Operationalized for Portugal in Institutionalized Elderly: A Cross-Sectional Study]. ACTA MEDICA PORT 2021; 34:741-748. [PMID: 33159720 DOI: 10.20344/amp.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/22/2019] [Accepted: 02/24/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The consumption of potentially inappropriate medicines is high among institutionalized elderly, predisposing to potential drug interactions, adverse drug events, risk of iatrogenic cascade, increased morbidity and mortality and health costs. Medication review is a promising strategy for therapeutic optimization, although scarcely documented in Portugal. The aim of this study was to characterize, using explicit criteria, the existence of potentially inappropriate medicines, among institutionalized elderly, and to calculate the eventual cost savings, with their discontinuation. MATERIAL AND METHODS Descriptive and cross-sectional study conducted in three residential homes for the elderly, from different geographic regions, based on a random sample of 33 health records. In order to characterize the existence of potentially inappropriate medicines, we used the 2015 Beers criteria, revised by the American Geriatrics Society and in the Portuguese version. RESULTS On average, 11 drugs are prescribed to elderly residents of three residential structures for the elderly. All health records contain potentially inappropriate medicines (mean 4.8 ± 2.0 per resident), with anxiolytics (17.7%), antidepressants (17.7%) and antipsychotics (15.8%) being the most prevalent. Its reduction would result in an average monthly savings of €9.6 per resident. DISCUSSION The consumption of potentially inappropriate medicines is higher than the literature describes, and the cost of medicines is high. The involvement of nurses in the process of drug management and reconciliation, in coordination with the physician, could be an effective strategy. This is the first study using the latest Portuguese version of the Beers criteria, which makes the comparability of the results difficult. CONCLUSION The consumption of potentially inappropriate medicines is high, which suggest the need for adoption of improvement measures.
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Affiliation(s)
- Sofia Peixoto
- Departamento de Gerontologia e Cuidado Geriátrico. Universidade Católica Portuguesa. Instituto de Ciências da Saúde. Porto. Portugal
| | - Armando Almeida
- Centro de Investigação Interdisciplinar em Saúde. Universidade Católica Portuguesa. Porto. Portugal
| | - Ana Caramelo
- Centro de Investigação Interdisciplinar em Saúde. Universidade Católica Portuguesa. Porto. Portugal
| | - Lígia Mendes
- Departamento de Medicina Geral e Familiar. Assistência Social Adventista. Lisboa. Portugal
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Kovacevic B, Caramelo A, Skuletic V, Cerovic S, Eloy C. EWSR1 rearrangement in papillary thyroid microcarcinoma is related to classic morphology and the presence of small-cell phenotype. Bosn J Basic Med Sci 2021; 22:54-63. [PMID: 34374640 PMCID: PMC8860317 DOI: 10.17305/bjbms.2021.6181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/31/2021] [Indexed: 11/16/2022] Open
Abstract
The EWSR1 rearrangements with unknown genes were detected in a high percentage of classic variants of papillary thyroid carcinoma. The small-cell carcinoma of the thyroid with Ewing family tumor elements (CEFTE) typically presents with EWSR1-FLI1 rearrangement suggesting the possible role of EWSR-FLI1 translocation in the loss of thyroid differentiation and acquisition of a small-cell phenotype. In order to determine the frequency and association of EWSR1 rearrangements, particularly the EWSR1-FLI1 fusion with clinicopathological features of papillary thyroid microcarcinoma (m-PTC) and the presence of small cells, we analyzed a series of 99 m-PTCs using the fluorescence in situ hybridization method. Ninety cases (90.9%) of m-PTC were positive for small cells. This group of m-PTC has shown more often invasive growth, lymphatics invasion, and moderate/extended intratumoral fibrosis. Three cases out of 99 were inconclusive for EWSR1 rearrangement. Eighty-nine (92.7%) and twenty-seven (28.1%) out of 96 m-PTC cases were positive for EWSR1 rearrangement and EWSR1-FLI1 fusion, respectively. m-PTC with classical architectural pattern presented more frequently with EWSR1 rearrangement relative to m-PTC with other patterns (p = 0.005). Other clinicopathological features were not related to the presence of EWSR1 rearrangement or EWSR1-FLI1 fusion. The percentage of small cells present significantly correlated with the percentage of cells positive for EWSR1-FLI1 fusion (p = 0.05) and EWSR1 rearrangement (p <0.001). EWSR1-FLI1 fusion is not rare in m-PTC and it is associated with the acquisition of small-cell phenotype. The EWSR1 gene rearrangement is a frequent event in m-PTC and is related to the classical pattern of m-PTC.
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Affiliation(s)
- Bozidar Kovacevic
- Institute of Pathology and Forensic Medicine, Military Medical Academy
| | - Ana Caramelo
- Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology of Porto University, Ipatimup, Porto, Portugal
| | - Vesna Skuletic
- Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia
| | - Snezana Cerovic
- Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia
| | - Catarina Eloy
- Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology of Porto University, Ipatimup, Porto, Portugal; Medical Faculty, University of Porto, Porto, Portugal
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Polónia A, Caramelo A. HER2 in situ hybridization test in breast cancer: quantifying margins of error and genetic heterogeneity. Mod Pathol 2021; 34:1478-1486. [PMID: 33980971 DOI: 10.1038/s41379-021-00813-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 11/09/2022]
Abstract
The aim of the present study was to evaluate the effect of counting increasing number of invasive cancer cells in the result of the HER2 in situ hybridization (ISH) test in breast cancer as well as to compare two different approaches of measuring genomic heterogeneity (single cell and population based). A cohort of 100 consecutive breast cancer cases (primary and metastatic) were evaluated for HER2 gene amplification with bright-field ISH. The evaluation of the samples included scoring 20 nuclei, in five different areas, measuring the margins of error for each case. Genomic heterogeneity (GH) was defined by the 2018 ASCO/CAP guideline as a discrete population of tumor cells with HER2 amplification. We also evaluated GH as single tumor cells with HER2 amplification. The stabilization of the coefficient of variation of HER2/CEP17 ratio requires about 60 invasive cancer cells. The average margin of error of HER2/CEP17 ratio and of HER2 copy number was 0.40 and 0.53, respectively, when counting 20 cells, decreasing to 0.20 and 0.26 when counting 100 cells. Population GH was observed in 1% of the cases, while single cell GH was observed in 27% of the cases, reaching its maximum value in cases near the thresholds of positivity. Therefore, margins of error in HER2 ISH test are high, and the minimal cell number recommended in current guidelines should be raised to at least 60 cells. Population GH is a rare event and single cell GH is maximal in cases near the thresholds.
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Affiliation(s)
- António Polónia
- Department of Pathology, Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal. .,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
| | - Ana Caramelo
- Department of Pathology, Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
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Fonseca L, Freitas C, Caramelo A, Eloy C. Expression of PD-L1 in medullary thyroid carcinoma-a new therapeutic target? Endocrinol Diabetes Metab 2021; 4:e00241. [PMID: 34277966 PMCID: PMC8279617 DOI: 10.1002/edm2.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Liliana Fonseca
- Endocrinology, Diabetes and Metabolism Department Centro Hospitalar e Universitário do Porto Porto Portugal
| | - Cláudia Freitas
- Endocrinology, Diabetes and Metabolism Department Centro Hospitalar e Universitário do Porto Porto Portugal
| | - Ana Caramelo
- Institute of Molecular Pathology and Immunology University of Porto - IPATIMUP Porto Portugal
| | - Catarina Eloy
- Institute of Molecular Pathology and Immunology University of Porto - IPATIMUP Porto Portugal.,Faculty of Medicine University of Porto Porto Portugal
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Aloqaily A, Polonia A, Campelos S, Alrefae N, Vale J, Caramelo A, Eloy C. Digital Versus Optical Diagnosis of Follicular Patterned Thyroid Lesions. Head Neck Pathol 2020; 15:537-543. [PMID: 33128731 PMCID: PMC8134627 DOI: 10.1007/s12105-020-01243-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To study the concordance between pathologists in the diagnosis of follicular patterned thyroid lesions using both digital and conventional optical settings. MATERIAL AND METHODS Five pathologists reviewed 50 hematoxylin and eosin-stained slides of follicular patterned thyroid lesions using both digital (the D-Sight 2.0 scanner and navigator viewer) and conventional optical instruments with washout interval time. RESULTS The mean concordance rate with the ground truth (GT) was similar between conventional optical and digital observation (83.2 and 85.2%, respectively). The most frequent reason for diagnostic discordance with GT on both systems was the evaluation of nuclear features (69.1% for conventional optical observation and 59.4% for digital observation). The intraobserver diagnostic concordance mean was 86.8%. Time for digital observation (mean time per case = 2.9 ± 0.8 min) was higher than that for conventional optical observation (mean time per case = 2.0 ± 0.7 min). Interobserver correlation of measurements was higher in the digital observation than the conventional optical observation. CONCLUSION Conventional optical and digital observation settings showed a comparable accuracy for the diagnosis of follicular patterned thyroid nodules, as well as substantial intraobserver agreement and a significant improvement in the reproducibility of the measurements that support the use of digital diagnosis in thyroid pathology. The origins underlying the variability of the diagnosis were the same in both conventional optical microscopy and digital pathology systems.
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Affiliation(s)
- Ayat Aloqaily
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal ,grid.460946.90000 0004 0411 3985King Abdullah University Hospital (KAUH), Jordan, University of Science and Technology (JUST), Irbid, Jordan
| | - Antonio Polonia
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal ,grid.5808.50000 0001 1503 7226Instituto de Investigação E Inovação Em Saúde (i3S), University of Porto, Porto, Portugal
| | - Sofia Campelos
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
| | - Nusaiba Alrefae
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal ,Kuwait Institute for Medical Specializations, Kuwait, Kuwait
| | - Joao Vale
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
| | - Ana Caramelo
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
| | - Catarina Eloy
- grid.5808.50000 0001 1503 7226Institute of Molecular Pathology and Immunology, Ipatimup Diagnostics, University of Porto (IPATIMUP)/i3S, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal ,grid.5808.50000 0001 1503 7226Medical Faculty, Porto University, Porto, Portugal ,grid.5808.50000 0001 1503 7226Instituto de Investigação E Inovação Em Saúde (i3S), University of Porto, Porto, Portugal
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