Immunohistochemical biomarker scoring in gastroesophageal cancers: Can computers help us?

Journal: Pathology, research and practice
Published Date:

Abstract

The increasing complexity of cancer diagnostics and treatment selection has placed a growing burden on pathologists, particularly in the evaluation of immunohistochemical (IHC) biomarkers. In gastroesophageal cancers (GEC), both adenocarcinoma and squamous cell carcinoma subtypes, multiple prognostic and predictive biomarkers must be assessed to guide therapy. These evaluations require meticulous scoring, are time-consuming, and suffer from inter- and intra-observer variability. Given the worldwide shortage of pathologists, artificial intelligence (AI)-based tools have emerged as a potential solution to enhance efficiency and accuracy in biomarker scoring. This review aims to answer the question captured in its title: can AI help us in IHC biomarker scoring in GEC, and if so, how? A search of PubMed and Google Scholar was conducted to identify relevant studies. The analysis reveals that AI has demonstrated promise in improving reproducibility and reducing pathologist workload for biomarkers such as PD-L1 and HER2, although its applications in GEC remain limited compared to other cancer types. In parallel, predictive computational approaches are emerging that could revolutionize biomarker scoring altogether. By alleviating the burdens of complex scoring systems and costly additional assays, AI could have the potential to significantly enhance pathology practice in GEC biomarker evaluation.

Authors

  • Alessandro Caputo
    Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
  • Valentina Angerilli
    Surgical Pathology Unit, ULSS2 Marca Trevigiana, Treviso, Italy.
  • Alessandro Gambella
    A.O.U. Città della Salute e della Scienza Hospital, Division of Pathology, Corso Bramante 88, Turin, 10126, Italy.
  • Vincenzo L'Imperio
    Department of Medicine and Surgery, ASST Monza, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
  • Giuseppe Perrone
    Department of Medicine and Surgery, Research Unit of Anatomical Pathology, Università Campus Bio-Medico di Roma, Roma, Italy.
  • Chiara Taffon
    Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy.
  • Massimo Milione
    Filiberto Belli, Carlo Corbellini, Ermanno Leo, Colorectal Surgery Unit, National Cancer Institute, 20133 Milan, Italy.
  • Federica Grillo
    Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy.
  • Luca Mastracci
    Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy.
  • Alessandro Vanoli
    Department of Molecular Medicine, University of Pavia, Pavia, Italy; Anatomic Pathology, IRCCS San Matteo Hospital Foundation, Pavia, Italy.
  • Paola Parente
    Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo 71013, Italy. Electronic address: paolaparente77@gmail.com.
  • Matteo Fassan
    Department of Medicine (DIMED), University of Padua, Padua, Italy; Veneto Institute of Oncology (IOV.IRCCS), Padua, Italy. Electronic address: matteo.fassan@unipd.it.