title: Computer-assisted pathological immunohistochemistry scoring is more time-effective than conventional scoring, but provides no analytical advantage.
abstract: OBJECTIVE
  Interpretation of immunohistochemistry is primarily done through human visual scoring while computer-assisted scoring is relatively uncommon. This study aimed to examine (i) the level of agreement between human visual and computer-assisted pathological scoring of immunoreactivity expression in colorectal cancers, (ii) whether computer-assisted scoring affects the prognostic significance of biomarkers, and (iii) whether computer-assisted pathological scoring provides any time-saving or reproducibility advantages.
  
  
  RESULTS
  Tissue microarray blocks were constructed from the primary colorectal adenocarcinoma specimens of 486 patients. Scoring of the six markers [cytokeratin (CK) 7, CK20, cyclooxygenase-2, Ki67, p27 and p53] was done independently by a qualified pathologist, a trained scientist and the Ariol SL-50 (Applied Imaging). Univariate analysis showed that human visual and computer-assisted scoring were strongly correlated (all kappa values >0.8). Both human visual and computer-assisted pathological scoring identified the same set of biomarkers with significant association with survival. Computer-assisted pathological scoring was shown to be a time-effective means of scoring larger numbers of slides (for high-throughput studies).
  
  
  CONCLUSIONS
  Our results suggest that computer-assisted pathological scoring can be a viable alternative to pathologist scoring in a manner that is more practical and time-effective, but, interestingly, providing no analytical advantage.
authors.affiliation: Department of Pathology, National University of Singapore, 5 Lower Kent Ridge Road, Singapore, Singapore.
authors.forename: Chee Wee
authors.initials: CW
authors.lastname: Ong
authors.forename: Lay Gek
authors.initials: LG
authors.lastname: Kim
authors.forename: Hui Hui
authors.initials: HH
authors.lastname: Kong
authors.forename: Lai Yee
authors.initials: LY
authors.lastname: Low
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Wang
authors.forename: Srivastava
authors.initials: S
authors.lastname: Supriya
authors.forename: Manickam
authors.initials: M
authors.lastname: Kathiresan
authors.forename: Richie
authors.initials: R
authors.lastname: Soong
authors.forename: Manuel
authors.initials: M
authors.lastname: Salto-Tellez
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry / Q000379:methods*; D008297:Male; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor