Abstract
The aim of this retrospective pilot study was to evaluate the Aperio nuclear V9 algorithm as an image analysis tool to observe the histopathological changes of ocular surface squamous neoplasia (OSSN). A histopathological assessment, including the Ki-67 proliferative index (PI) of immunohistochemically-stained tumor conjunctiva (TC) and healthy conjunctiva (HC) tissues, was performed in six cases of OSSN. The Aperio V9 algorithm was applied to digital images of the tissue specimens to count the Ki-67 PI and to measure the nuclear area indices. This digital algorithm was validated using stereological and visual analysis methods. The visual scoring of Ki-67 PI ranged from 22 to 60% (mean, 38.5%), and from 5 to 20% (mean 9.5%) in TC and HC tissue, respectively. The computer-aided analysis, using the Aperio nuclear V9 algorithm, revealed that the Ki-67 PI ranged from 21.5 to 43.5% (mean, 33.6%), and from 1.9 to 21.0% (mean, 11.8%) in the TC and HC tissue, respectively. The stereological method demonstrated that the Ki-67 PI ranged from 30.1 to 51.5% (mean, 41.0%), and from 3.2 to 30.1% (mean, 15.1%) in the TC and HC tissues, respectively. The strongest association in the collinearity of regression analysis was observed between the Aperio nuclear V9 algorithm/stereological models in the TC tissue (r2=0.7; P=0.04) and the HC tissue (r2=0.7; P=0.03), and the visual/stereological models in the TC tissue (r2=0.7; P=0.04) and the visual/Aperio nuclear V9 algorithm models in the HC tissue (r2=0.7; P=0.04). A weak and statistically insignificant association was identified between the visual/Aperio nuclear V9 algorithm analysis in the TC tissue (r2=0.4; P=0.2) and the visual/stereological models in the HC tissue (r2=0.5; P=0.13). No significant difference was observed between the nuclear area of the TC (mean, 36.5 μm2) and HC (mean, 35.7 μm2; P=0.88) tissues. It was concluded that the Aperio nuclear V9 algorithm is a useful tool for the reliable analysis of histopathological changes of OSSN. The results of this computer-aided algorithm correlate strongly with the stereological method when assessing the Ki-67 PI.
Highlights
During the last decade, automated diagnostic image analysis methods have been developed to improve the standardization and reproducibility of the results of histopathological evaluation
There are different computer‐assisted software tools for automatic IHC analysis based on whole‐slide imaging, including Aperio software (Aperio Technologies; Vista, CA, USA), an integrated scanning and image analysis system
ocular surface squamous neoplasia (OSSN) was diagnosed in six patients with a mean age of 69 years
Summary
During the last decade, automated diagnostic image analysis methods have been developed to improve the standardization and reproducibility of the results of histopathological evaluation. There are different computer‐assisted software tools for automatic IHC analysis based on whole‐slide imaging, including Aperio software (Aperio Technologies; Vista, CA, USA), an integrated scanning and image analysis system. This tool incorporates positive pixel count nuclear, membrane and cytoplasmic algorithms, can be employed to measure areas and staining properties [1]. Objective and reproducible automated analysis has been shown to facilitate diagnosis, prognosis and management of oncologic diseases [5‐6]. To the best of our knowledge, there are no studies concerning automated analysis using the Aperio algorithms in the cases of ocular surface squamous neoplasia (OSSN)
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