Frontiers in Oncology (Jul 2021)

Digital Pathology Scoring of Immunohistochemical Staining Reliably Identifies Prognostic Markers and Anatomical Associations in a Large Cohort of Oral Cancers

  • Julius Moratin,
  • Andreas Mock,
  • Andreas Mock,
  • Sonja Obradovic,
  • Karl Metzger,
  • Christa Flechtenmacher,
  • Karim Zaoui,
  • Stefan Fröhling,
  • Dirk Jäger,
  • Jürgen Krauss,
  • Jürgen Hoffmann,
  • Kolja Freier,
  • Dominik Horn,
  • Jochen Hess,
  • Christian Freudlsperger

DOI
https://doi.org/10.3389/fonc.2021.712944
Journal volume & issue
Vol. 11

Abstract

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Utilizing digital pathology algorithms for the objective quantification of immunohistochemical staining, this study aimed to identify robust prognostic biomarkers for oral cancer. Tissue microarrays with specimens of a large cohort of oral squamous cell carcinoma (n=222) were immunohistochemically stained to determine the expression of PD-L1, EGFR, and COX-2 and the amount of infiltrating NK cells and CD8-positive T cells. Immunoreactivity scores were assessed using both a classical manual scoring procedure and a digital semi-automatic approach using QuPath. Digital scoring was successful in quantifying the expression levels of different prognostic biomarkers (CD8: p<0.001; NK cells: p=0.002, PD-L1: p=0.026) and high levels of concordance with manual scoring results were observed. A combined score integrating EGFR expression, neck node status and immune cell signatures with a significant impact on overall and progression-free survival was identified (p<0.001). These data may contribute to the ongoing research on the identification of reliable and clinically relevant biomarkers for the individualization of primary and adjuvant treatment in oral cancer.

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