Invasive pattern grading score designed as an independent prognostic indicator in oral squamous cell carcinoma

Chang, Yun-Ching; Nieh, Shin; Chen, Su-Feng; Jao, Shu-Wen; Lin, Yu-Lu; Fu, Earl

doi:10.1111/j.1365-2559.2010.03616.x

Cited by 45 publications

(50 citation statements)

References 28 publications

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“…Regarding the single histopathological features, Sawair et al found moderate Kappa values for keratinisation (0.48) and even worse ones for pattern of invasion 33. Analysis of Kappa values for the pattern of invasion as defined by the Royal College of Pathologists34 resulted in kappa values between 0.43 and 0.58 in a study by Beggan et al ,35 whereas Heerema et al found values between 0.25 and 0.5853 and Chang et al a value of 0.72 36. Interobserver agreement of the HR model was good with κ =0.84 37.…”

Section: Discussionmentioning

confidence: 98%

Novel prognostic histopathological grading system in oral squamous cell carcinoma based on tumour budding and cell nest size shows high interobserver and intraobserver concordance

et al. 2018

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AimsSquamous cell carcinoma of the oral cavity (OSCC) is a common tumour entity with a variable, partially highly aggressive clinical course. Recently, we proposed a novel (three-tiered) clinically useful grading scheme strongly associated with patient outcome in OSCC, consisting of a sum score of the histomorphological patterns tumour budding and cell nest size which outperforms WHO based grading algorithms currently in use. The aim of our study was to probe for interobserver and intraobserver reliability of this novel grading system.Methods108 OSCC were retrospectively scored according to the proposed grading scheme by three independent pathologists—two experienced head and neck pathologists and one pathologist in training—blinded to each other’s scoring results.ResultsThe Cohen’s Kappa (κ) values for concordance rates between experienced pathologists were κ=0.97 for the overall grade, κ=0.97 for budding activity and κ=0.91 for cell nest size, indicating a strong interobserver reliability of our proposed grading system. Initial interobserver agreement was markedly lower with the pathologist in training (κ=0.55 for overall grade) but improved significantly after a training session (κ=0.87 for overall grade). Intraobserver concordance was high (κ=0.95 for overall grade), indicating a high reproducibility of the algorithm.ConclusionsIn conclusion, our study indicates that OSCC grading based on our proposed novel scheme yields an excellent inter-reader and intrareader agreement, further supporting the suitability of this grading system for routine pathological practice.

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Section: Discussionmentioning

confidence: 98%

Novel prognostic histopathological grading system in oral squamous cell carcinoma based on tumour budding and cell nest size shows high interobserver and intraobserver concordance

et al. 2018

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“…7,10,38 None of these features are based on the actual morphologic attributes of the tumors. Patients that were identified with poor prognosis by the classifier were 12 times more likely to suffer from disease recurrence, and six times more likely to develop distant metastases.…”

Section: Discussionmentioning

confidence: 99%

An oral cavity squamous cell carcinoma quantitative histomorphometric-based image classifier of nuclear morphology can risk stratify patients for disease-specific survival

Lewis

Dupont

et al. 2017

Modern Pathology

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Oral cavity squamous cell carcinoma is the most common type of head and neck carcinoma. Its incidence is increasing worldwide, and it is associated with major morbidity and mortality. It is often unclear which patients have aggressive, treatment refractory tumors vs those whose tumors will be more responsive to treatment. Better identification of patients with high- vs low-risk cancers could help provide more tailored treatment approaches and could improve survival rates while decreasing treatment-related morbidity. This study investigates computer-extracted image features of nuclear shape and texture on digitized images of H&E-stained tissue sections for risk stratification of oral cavity squamous cell carcinoma patients compared with standard clinical and pathologic parameters. With a tissue microarray cohort of 115 retrospectively identified oral cavity squamous cell carcinoma patients, 50 were randomly chosen as the modeling set, and the remaining 65 constituted the test set. Following nuclear segmentation and feature extraction, the Wilcoxon rank sum test was used to identify the five most prognostic quantitative histomorphometric features from the modeling set. These top ranked features were then combined via a machine learning classifier to construct the oral cavity histomorphometric-based image classifier (OHbIC). The classifier was then validated for its ability to risk stratify patients for disease-specific outcomes on the test set. On the test set, the classifier yielded an area under the receiver operating characteristic curve of 0.72 in distinguishing disease-specific outcomes. In univariate survival analysis, high-risk patients predicted by the classifier had significantly poorer disease-specific survival (P = 0.0335). In multivariate analysis controlling for T/N-stage, resection margins, and smoking status, positive classifier results were independently predictive of poorer disease-specific survival: hazard ratio (95% confidence interval) = 11.023 (2.62–46.38) and P = 0.001. Our results suggest that quantitative histomorpho-metric features of local nuclear architecture derived from digitized H&E slides of oral cavity squamous cell carcinomas are independently predictive of patient survival.

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“…[32,34] However, it has become clear that the histopathological information gained from multiple biopsies taken from different parts of the invasive front of the cancer has a more significant prognostic value. [35] In the population of greater Johannesburg in South Africa, oral leukoplakia occurs significantly more frequently in white than in black persons, [17,36] but as this study shows that black and white persons are affected by OSCC more or less equally, it is reasonable to assume that in Johannesburg, OSCC develops de novo more frequently in blacks than in whites. This suggests that in some way the pathogenesis of OSCC may be different in black and white persons.…”

Section: Sd = Standard Deviationmentioning

confidence: 90%

Oral squamous cell carcinoma in a South African sample: Race/ethnicity, age, gender, and degree of histopathological differentiation

2014

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Invasive pattern grading score designed as an independent prognostic indicator in oral squamous cell carcinoma

Abstract: Our study confirms the validity of the IPGS, an indicator that is simple and easy to use. IPGS not only provides histological assessment of biological behaviour, but also offers an independent prognostic factor that may influence the treatment of OSCC.

Cited by 45 publications

References 28 publications

Novel prognostic histopathological grading system in oral squamous cell carcinoma based on tumour budding and cell nest size shows high interobserver and intraobserver concordance

Novel prognostic histopathological grading system in oral squamous cell carcinoma based on tumour budding and cell nest size shows high interobserver and intraobserver concordance

An oral cavity squamous cell carcinoma quantitative histomorphometric-based image classifier of nuclear morphology can risk stratify patients for disease-specific survival

Oral squamous cell carcinoma in a South African sample: Race/ethnicity, age, gender, and degree of histopathological differentiation

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