Carcinoma Biopsies Research Articles

A touch-free human-robot collaborative surgical navigation robotic system based on hand gesture recognition.

Robot-assisted minimally invasive surgery (RAMIS) has gained significant traction in clinical practice in recent years. However, most surgical robots rely on touch-based human-robot interaction (HRI), which increases the risk of bacterial diffusion. This risk is particularly concerning when surgeons must operate various equipment with their bare hands, necessitating repeated sterilization. Thus, achieving touch-free and precise manipulation with a surgical robot is challenging. To address this challenge, we propose a novel HRI interface based on gesture recognition, leveraging hand-keypoint regression and hand-shape reconstruction methods. By encoding the 21 keypoints from the recognized hand gesture, the robot can successfully perform the corresponding action according to predefined rules, which enables the robot to perform fine-tuning of surgical instruments without the need for physical contact with the surgeon. We evaluated the surgical applicability of the proposed system through both phantom and cadaver studies. In the phantom experiment, the average needle tip location error was 0.51 mm, and the mean angle error was 0.34 degrees. In the simulated nasopharyngeal carcinoma biopsy experiment, the needle insertion error was 0.16 mm, and the angle error was 0.10 degrees. These results indicate that the proposed system achieves clinically acceptable accuracy and can assist surgeons in performing contactless surgery with hand gesture interaction.

Current trends in liquid biopsy and diagnostics-contributions from ASCO and ESMO 2022

Liquid biopsy is apromising new diagnostic tool that is already used in clinical practice for multiple tumor entities and which also has great potential for head and neck cancer. Herein, the authors discuss aselection of publications from the American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) meetings in 2022. Relevant publications are evaluated and summarized. Using adatabank inquiry, abstracts from the 2022 ASCO and ESMO conferences regarding liquid biopsy and related diagnostics for head and neck squamous cell carcinoma were collected. Work without relevant data and statements of intent were not included. Duplicate articles across conferences were only quoted once. Atotal of532articles were screened, 50articles were selected for further review, and 9articles were selected for presentation. Six articles on cell- and RNA-based liquid biopsy and three articles on more general diagnostic tools in the treatment of head and neck cancer are presented. The results are discussed in relation to current treatment standards. Multiple studies show promising results for the use of circulating tumor DNA (ctDNA) for treatment surveillance in head and neck cancer. Integration into clinical practice will depend on larger study cohorts and sinking costs.

Morphometric Features of Cells of Cervical Intraepithelial Neoplasia Using Computer Aided Image Analysis

Aim: Our goal is to evaluate and compare the different cell morphometric parameters in the various categories of cervical intraepithelial neoplasia (CIN).
 Study Design: We conducted a cross-sectional study of all cervical intraepithelial neoplasia identified in some areas of biopsies of cervical carcinomas.
 Place and Duration of Study: The study was in the department of histopathology of LAUTECH Teaching Hospital, Osogbo from January 2006 to December 2015.
 Materials and Methods: The histologic slides produced were scanned using CS2 APERIO digital slide scanner with standard settings. The scanned slides were then viewed using Qu Path-0.3.2 software. All areas of cervical intraepithelial neoplasia were selected. The perimeter, area, maximum caliper, circularity, eccentricity, and the various measures of hematoxylin optic densities (OD) of the nucleus of the cells were measured. The cytoplasmic morphometric measurements and the nuclear-cell ratio were then estimated.
 Results: Two cases of CIN 1, one case of CIN 2 and one case of CIN 3 were seen in the background of the eighty-seven cases of cervical carcinomas seen during the study period. A total of 5,935 cells were in the annotated regions with cervical intraepithelial neoplasia. The cells in CIN 1 area are 3,828, CIN 2 area has 1183 cells and CIN 3 areas has 924 cells. Cells of CIN 3 had higher average nuclei hematoxylin optic density (OD), nuclei hematoxylin OD standard deviation and maximum hematoxylin OD than cells of CIN 2 and CIN 1. Cells of CIN 1 have higher average cell area, cell perimeter, cell circularity and mean cytoplasm eosin OD compared to cells of CIN 2 and 3.
 Conclusion: Computer-aided image analysis using Qu Path software can be very instrumental in differentiating the various categories of cervical intraepithelial neoplasia especially in fragmented biopsies.

Reducing the Use of Frozen Section for Sentinel Node Biopsy in Breast Carcinoma: Feasibility and Outcome.

Sentinel lymph node biopsy (SLNB) is a standard practice for staging the axilla in breast cancer. Initially, intraoperative frozen section (FS) examination was used but was time-consuming and often provided false-negative results. Delayed permanent section (PS) analysis is currently performed; FS-SLNB is maintained for selected high-risk cases. The aim of this study was to evaluate the feasibility of this approach. All patients with breast cancer with clinically negative lymph nodes undergoing SLNB at our institution from 2004 to 2020 were analyzed, comparing operative time, re-operation rate and clinical outcome in terms of regional lymphatic recurrence-free and overall survival by type of SLNB (FS vs. PS). FS-SLNB comprised 100% of the procedures in 2004 and 18.2% at the end of the study period. The use of PS-SLNB instead of FS-SLNB was associated with a significantly reduced rate of axillary dissection (AD): 4.4% vs. 27.2, respectively (p<0.001). There was no significant difference in re-operation rate for AD: 3.9% vs. 6.9%, respectively (p=0.20). The use of PS-SLNB significantly reduced the operative time (mean=51 minutes) (p<0.001). After a mean follow-up of 70.9 months (range=16-180 months) there were no differences in regional lymphatic recurrence free or overall survival. The reduced use of FS-SLNB resulted in a significantly lower rate of AD, and significant operative time and costs savings, without any increase in the reoperation rate and lymphatic recurrences. Therefore, this approach is feasible, safe and beneficial, both for patients and healthcare services.

Agreement Between Mucicarmine-Stained Bronchial Brushing and Bronchial Biopsy in Subtyping Non-small Cell Lung Carcinoma.

Background Bronchial brushing and biopsy are used for the diagnosis of lung carcinoma as most of these tumors are unresectable. Recently, the subclassification of non-small cell lung carcinoma (NSCLC) into adenocarcinoma (ADC) and squamous cell carcinoma (SCC) has become mandatory due to the emergence of targeted therapies. Due to the inherent limitations of small samples, subcategorization of a tumor is not always possible. Immunohistochemical and mucin stains are being used for this purpose, especially for tumors with poorly differentiated features. In our study, we utilized mucicarmine mucin stain to refine the differentiation of SCC and ADC on bronchial brushing and determine its agreement with bronchial biopsy. This study aimed to measure the degree of agreement between mucicarmine-stained bronchial brushing and bronchial biopsy for subtyping NSCLC into SCC and ADC. Methodology This descriptive, cross-sectional study was conducted in the pathology department of Allama Iqbal Medical College. Samples were collected by the pulmonology department of Jinnah Hospital Lahore. The study was conducted for 10 months from June 2020 to April 2021. A total of 60 cases diagnosed as NSCLC, aged between 35 and 80 years, were included in this study. After cytohistological evaluation of bronchial brushing and bronchial biopsy specimens, the agreement was deduced using kappa statistics. Results The strength of agreement between mucicarmine-stained bronchial brushing and bronchial biopsy for subtyping NSCLC into SCC and ADC was found to be substantial. Conclusions As significant agreement exists between the two modalities, mucicarmine-stained bronchial brushing can be used for a reliable and rapid categorization of NSCLC.

Diagnostic accuracy of combined optical- and radio-guided SNB for neck staging of oral squamous cell carcinoma lesions in the anterior oral cavity

PurposeThe purpose was to investigate the diagnostic performance of bimodal optical and radio-guided sentinel node biopsy (SNB) for oral squamous cell carcinoma (OSCC) sub-sites in the anterior oral cavity.MethodsProspective study of 50 consecutive patients with cN0 OSCC scheduled for SNB was injected with the tracer complex Tc99m:ICG:Nacocoll. A near-infrared camera was applied for optical SN detection. Endpoints were modality for intraoperative SN detection and false omission rate at follow-up.ResultsIn all patients, a SN could be detected. In 12/50 (24%) of cases, the SPECT/CT showed no focus in level 1, but intraoperatively a SN in level 1 was optically detected. In 22/50 cases (44%), an additional SN was identified only due to the optical imaging. At follow-up, the false omission rate was 0%.ConclusionOptical imaging appears to be an effective tool to allow real-time SN identification comprising level 1 unaffected by possible interference of radiation site from the injection.

Bilateral inguinal lymph-node dissection vs. unilateral inguinal lymph-node dissection and dynamic sentinel node biopsy in clinical N1 squamous cell carcinoma of the penis

To evaluate the role of unilateral inguinal lymph-node dissection (ILND) plus contralateral dynamic sentinel node biopsy (DSNB) vs. bilateral ILND in clinical N1 (cN1) penile squamous cell carcinoma (peSCC) patients. Within our institutional database (1980-2020, included), we identified 61 consecutive cT1-4 cN1 cM0 patients with histological confirmed peSCC who underwent either unilateral ILND plus DSNB (26) or bilateral ILND (35). Median age was 54 years (Interquartile range [IQR]: 48-60 years). Median follow-up was 68 months (IQR 21-105 months). Most patients had pT1 (23 %) or pT2 (54.1%), as well as G2 (47.5%) or G3 (23%) tumors, while lymphovascular invasion (LVI) was present in 67.1% of cases. Considering a cN1 and a cN0 groin, overall 57 out of 61 patients (93.5%) had nodal disease in the cN1 groin. Conversely, only 14 out of 61 patients (22.9%) had nodal disease in the cN0 groin. 5-year IR-free survival was 91% (Confidence interval [CI] 80%-100%) for bilateral ILND group and 88% (CI 73%-100%) for the ipsilateral ILND plus DSNB group (P-value 0.8). Conversely, 5-year CSS was 76% (CI 62%-92%) for bilateral ILND group and 78% (CI 63%-97%) for the ipsilateral ILND plus contralateral DSNB group (P-value 0.9). In patients with cN1 peSCC the risk of occult contralateral nodal disease is comparable to cN0 high risk peSCC and the gold standard, namely bilateral ILND, may be replaced by unilateral ILND and contralateral DSNB without affecting positive node detection, IRRs and CSS.

Prevalence of Thyroid Transcription Factor-1 (TTF-1)-Negative Small Cell Carcinoma and Napsin A Positivity in Small Cell Carcinoma in a Cross-Sectional Study of Lung Core Biopsies.

Background The prevalence of thyroid transcription factor-1 (TTF-1) and napsin A expression are poorly characterized in lung core biopsies of small cell carcinoma. Locally, the TTF-1 clone is 8G7G3/1 (Agilent/Dako), and the napsin A clone is IP64 (Leica Biosystems). Methods All in-house lung core biopsy reports for cases accessioned at a regional laboratory from January 2011 to December 2020 were retrieved and analyzed using a validated hierarchical free-text string matching algorithm (HFTSMA) to establish the diagnosis. TTF-1 and napsin A were manually coded with the assistance of a logical text parsing tool. All TTF-1-negative small cell lung carcinoma (SCLC) cases had a full report review by pathologists. Results The cohort had 5,867 lung core biopsies, and 232 cases were confirmed as small cell carcinoma on pathologist review. TTF-1 immunostain results were available in 173 SCLC cases, and 16 cases of TTF-1-negative SCLC were confirmed on full report review. These 16 cases had at least one positive neuroendocrine (NE) marker and positive keratin staining; cases with mixed histology or positiveCK5/6 staining were excluded. Ki-67 was done in 10/16 cases; the average Ki-67 was 75%. Napsin Awas negative in 50/51 small cell carcinomas, and 0/3 TTF-1-negative SCLC had napsin A positivity. Conclusions Standardized immunostain reporting would simplify such analyses. Based on thecohort, approximately 9% (16/173) of SCLCis TTF-1 negative. Napsin A positivity in suspected small cell carcinoma should prompt consideration of an alternate diagnosis or explanation.

Measures of performance for sentinel lymph node biopsy in oro-oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis

Measures of performance for sentinel lymph node biopsy in oro-oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis

Ligneous brochitis: A clinicopathological correlation of seven cases

Seven patients with ligneous lesions of the bronchus are presented. The patients are five men and two women between the ages of 51 and 79 years (average: 65) who had prior history of pulmonary non-small cell carcinoma in the past 2–3 years. All the patients had undergone surgical resection followed by chemotherapy. The patients were evaluated for the potential recurrence of carcinoma and bronchial biopsies were obtained. Histologically, all the cases shared similar features, manly the presence of a subepithelial amorphous, acellular, eosinophilic material with minimal inflammatory reaction. Special histochemical stains for micro-organisms were negative as well as congo red for the presence of amyloid. No evidence of malignancy was seen in any of the biopsies. The current cases, represent an unusual histological feature that is more in keeping with ligneous bronchitis, possibly secondary to treatment.

Prognostic and survival impact of BCL9 and RPS6KB1 copy number variation detected from circulating free DNA in hepatocellular carcinoma

ABSTRACT Background Circulating cell-free DNA (cfDNA) is a noninvasive substitute to liver biopsy for hepatocellular carcinoma (HCC) molecular profiling. This study aimed to use cfDNA to investigate copy number variation (CNV) in the BCL9 and RPS6KB1 genes and its impact on prognosis in HCC. Methods Real-Time Polymerase Chain Reaction was used to determine the CNV and cfDNA integrity index in 100 HCC patients. Results CNV gain in BCL9 and RPS6KB1 genes was detected in 14% and 24% of patients, respectively. Gain in CNV of BCL9 associated with risk of HCC in alcohol drinkers and hepatitis C seropositivity. In patients with RPS6KB1 gain, HCC risk increased with a high body mass index, smoking, schistosomiasis, and Barcelona clinical liver cancer stage (BCLC) A. Gain in both genes showed a high risk of HCC with elevated liver enzymes, Schistosomiasis, BCLC C, and PS > 1. The integrity of cfDNA was higher in patients with CNV gain in RPS6KB1 than those harboring CNV gain in BCL9. Lastly, BCL9 gain and BCL9 + RPS6KB1 gain led to higher mortality rates and reduced survival times. Conclusion cfDNA was used to detect BCL9 and RPS6KB1 CNVs, which influence prognosis and can be used as independent predictors of HCC patient survival.

Immunohistochemical Expression Of Cyclind1 In Conventional Squamous Cell Carcinomaof Oral Cavity.

Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm of the oral cavity, the incidence of which has significantly increased in the last 10 years. In Pakistan, it is reported to be the most common cancer among men and the second most common in women. Cyclin D1 is a protein involved in cell cycle regulation from G1 phase to S phase. Down regulation of this molecule causes inhibition of cell cycle transition and may lead to carcinogenesis. We studied the expression of Cyclin D1 in biopsies of oral squamous cell carcinoma to evaluate the staining patterns in various grades and sites of the oral cavity. Cyclin D1 was expressed in 53.8% cases of OSCC and showed a significant association with tumour differentiation, with higher intensity staining seen in poorly differentiated cases of OSCC. Thus, Cyclin D1 can be regarded as a marker of malignant potential of OSCC and can help identify cases with poorer outcome.

Thyroid Fine Needle Aspiration, the Bethesda System, and the BRAFV600E Mutation in Papillary Thyroid Carcinoma: Association and Prediction for Biopsy

Introduction: BRAFV600E mutations have been associated with papillary thyroid carcinoma (PTC) histological types including tall-cell and classical, peritumoral infiltration, and nuclear signs, whereas cytological features such as plump cells and sickle nuclei have also been associated with favorable thyroid fine needle aspiration (FNA) results for this tumor. BRAF and RAS are considered early driver mutations that contribute to the development of BRAF-like PTCs and RAS-like PTCs. Our aim was to assess the possible association between all Bethesda System cytological features and thyroid FNAs for PTC and their potential predictive value for future BRAFV600E-related biopsies. Methods: Our study analyzed 63 cases of PTCs operated on at our hospital over a 5-year period between 2005 and 2017 that had previously undergone FNA and had been classified by the Bethesda System. BRAFV600E was identified by pyrosequencing paraffin-embedded tissues and comparing the cytological signs with the Bethesda System. In addition, a statistical and predictive study of the diagnostic factors “non-follicular,” “non-round nuclei,” and “non-clear chromatin” was performed to discriminate BRAF-like signs from other hypothetical RAS-like follicular signs. Results: BRAFV600E was detected in 43/63 cases (68.2%). Histological types were significant (p < 0.001), with the classical variant being the most prevalent 31/63 (49.2%) and independent by multivariate analysis odds ratio of 10.58 [2.67; 41.97]. Follicular cytological signs are negatively associated with BRAFV600E: follicular structure (p < 0.001), round nuclei (p = 0.015), and clear chromatin (p = 0.049), while the diagnostic factors: “non-follicular” (positive predictive value [PPV] 82.9, sensitivity 79.1, negative predictive value [NPV] 59.1, specificity 65.0), “non-round nuclei” (PPV 76.6, sensitivity 83.7, NPV 56.3, specificity 45.0), and “non-clear chromatin” (PPV 75.6, sensitivity 79.1, NPV 50.0, specificity 45.0) have predictive value for the mutation. There was no individual significance for the remaining cytological features. Conclusions: Our study found no association between cytomorphological signs of thyroid FNA and BRAFV600E mutation. Considering the Bethesda System, there is an association (p = 0.045) with numerous cases of mutated PTC in categories V and VI. Our results indicate, however, that the presence of signs referred to as “non-follicular,” “non-round nuclei,” and “non-clear chromatin” in biopsy of papillary thyroid carcinoma is predictive of BRAF type mutation, whereas follicular signs indicate a RAS type PTC, according to published literature. These results need to be confirmed or modified by further research.

Role of SAR1B on Modulation of Nasopharyngeal Carcinoma Progression via Negative Regulation of Target of Rapamycin Complex 1 Signaling

To speculate an autophagy gene, secretion associated Ras related guanosine triphosphatase 1B related signaling pathway for nasopharyngeal carcinoma based on both in vitro and in vivo experiments. 120 nasopharyngeal carcinoma biopsies (pathologically confirmed) were analyzed and the differentially expressed genes were explored. The internal molecular mechanism was further investigated using the human nasopharyngeal carcinoma cell lines, CNE1, HONE1 and C666-1. The cell proliferation capacity examination and the metabolic assays were performed in CNE1 cell line. The subcutaneous xenograft tumor mice model was also established. Secretion associated Ras related guanosine triphosphatase 1B demonstrated a remarkable decreased activity in nasopharyngeal carcinoma tissues compared with sibling paracancerous tissues. The key components in mammalian target of rapamycin complex 1 but not mammalian target of rapamycin complex 2 were greatly enhanced in nasopharyngeal carcinoma tissues. Moreover, the secretion associated Ras related guanosine triphosphatase 1B displayed a significant decreasing expression pattern and the mammalian target of rapamycin complex 1 kept an upward trend as the tumor, node and metastases stage progressed. The clinical significances for nasopharyngeal carcinoma tumor progression were calculated based on statistical analysis. The cell proliferation assay suggested that secretion associated Ras related guanosine triphosphatase 1B manipulated nasopharyngeal carcinoma cell proliferation via mammalian target of rapamycin complex 1/p70 ribosomal protein kinase 1 dependent signaling pathway. At the same time, transfection of secretion associated Ras related guanosine triphosphatase 1B small interfering ribonucleic acid could significantly enhanced the glycolytic capacity and glycolytic reserve of nasopharyngeal carcinoma cells compared with negative control. Silencing of secretion associated Ras related guanosine triphosphatase 1B promoted xenograft tumour growth, which could be greatly suppressed by rapamycin treatment in a dosage-dependent manner. The study shed a variety of insights for nasopharyngeal carcinoma from an innovative direction.

Comparison between Laparoscopic and Robotic Approach for Sentinel Lymph Node Biopsy in Endometrial Carcinoma Women.

Robotic surgery has been approved as an alternative to laparoscopy to improve surgical outcomes. There is neither a consensus nor a systematic assessment of the literature about the superiority of the robotic approach over the laparoscopic one for sentinel lymph node (SLN) biopsy in endometrial carcinoma (EC) women. Therefore, a systematic review and meta-analysis was performed to compare the laparoscopic and robotic approaches for SLN biopsy in EC patients. Five electronic databases were queried from their inception to May 2022 for peer-reviewed studies, comparing such approaches in SLN biopsy in EC patients. The rate of detected SLN, dissected SLN, intraoperative and postoperative complications, conversion to laparotomy, number of dissected SLN, and SLN identification and dissection time were compared between the laparoscopic and robotic approaches for SLN biopsy in EC patients. Odds ratios with 95% confidence intervals were calculated when possible. Two studies with 660 EC women (364 who had undergone laparoscopy, and 296 who had robotic surgery) were included. No assessed outcome showed significant differences between the two approaches. In conclusion, the laparoscopic and robotic approaches for SLN biopsy in EC patients appeared to not differ, in terms of SLN detection, intraoperative and postoperative complications, conversion to laparotomy, number of dissected SLN, and SLN identification and dissection time.

Dual NGS Comparative Analysis of Liquid Biopsy (LB) and Formalin-Fixed Paraffin-Embedded (FFPE) Samples of Non-Small Cell Lung Carcinoma (NSCLC).

Lung cancer ranks second worldwide after breast cancer and third in Europe after breast and colorectal cancers when both sexes and all ages are considered. In this context, the aim of this study was to emphasize the power of dual analysis of the molecular profile both in tumor tissue and plasma by NGS assay as a liquid biopsy approach with impact on prognosis and therapy modulation in NSCLC patients. NGS analysis was performed both from tissue biopsies and from cfNAs isolated from peripheral blood samples. Out of all 29 different mutations detectable by both NGS panels (plasma and tumor tissue), seven different variants (24.13%; EGFR L858R in two patients, KRAS G13D and Q61H and TP53 G244D, V197M, R213P, and R273H) were detected only in plasma and not in the tumor itself. These mutations were detected in seven different patients, two of them having known distant organ metastasis. Our data show that NGS analysis of cfDNA could identify actionable mutations in advanced NSCLC and, therefore, this analysis could be used to monitor the disease progression and the treatment response and even to modulate the therapy in real time.

Novel Genetic Variant of 30-bp Deletion: A Polymorphism of Latent Membrane Protein 1 from Vietnamese Epstein Barr Virus-Associated Nasopharyngeal Carcinoma Biopsies

Novel Genetic Variant of 30-bp Deletion: A Polymorphism of Latent Membrane Protein 1 from Vietnamese Epstein Barr Virus-Associated Nasopharyngeal Carcinoma Biopsies

Fourier Transform Infrared Spectroscopy in the Study of Discrimination of Lobular Breast Cancers.

The early diagnosis of breast cancer plays an important role in reducing mortality and optimizing the prognosis of the disease. The existing visual and histopathological methods do not give any information at a molecular level. Fourier transform infrared spectroscopy does not require any preparation, such as fixation and histological stains. The collected infrared spectral "biomarker bands" give information at a molecular level and could be used for biomarker screening, in order to minimize the false-positive or false-negative results. For this prospective study, nine biopsies of lobular carcinoma (7 in situ and 2 invasive) and the adjacent healthy region of the biopsies were used. Each infrared spectrum consisted of 120 scans/spectrum (120 co-added spectra) at a spectral resolution of 4 cm -1 . The infrared spectral analysis revealed three important "diagnostic spectral regions" between 3,300-2,850 cm -1 , 1,700-1,500 cm -1 , and 850-800 cm -1 , which are related to membrane, collagen, and DNA configuration damage, respectively. The shift of the absorption band at 1,161 cm -1 at higher wave numbers up to 1,172 cm -1 is assigned to vC-O-C bonds due to membrane, protein, and DNA glycosylation. The "biomarker bands" at 1,172 cm -1 can be used as "diagnostic marker bands" for cancer progression. The shift of the absorbance band at 825 cm -1 of the native configuration of B-DNA to lower wavenumbers at 810 cm -1 Z-DNA in grade III, suggests the irreversible stage of the disease. The detection and possibility to differentiate the DNA structures may allow detection of carcinogenesis at the early stage of the disease, and development of new anticancer therapies.

P001 - Concordance of histological grade between pre-operative biopsy and resection specimen in penile squamous cell carcinoma

P001 - Concordance of histological grade between pre-operative biopsy and resection specimen in penile squamous cell carcinoma

Immune-related histologic phenotype in pretreatment tumour biopsy predicts the efficacy of neoadjuvant anti-PD-1 treatment in squamous lung cancer

BackgroundAlthough neoadjuvant anti-PD-1 immunotherapies have shown good efficacy in non-small cell lung cancer (NSCLC) patients, there is still a lack of effective predictive markers. We aimed to develop a pretreatment histologic scoring system to predict the efficacy of neoadjuvant immunotherapy.MethodsOne hundred forty NSCLC cases were evaluated in this study. Initially, surgical specimens from 31 squamous cell lung cancer patients treated with neoadjuvant anti-PD-1 therapy and their eligible paired pretreatment biopsies were used for pathologic evaluation and developing the pretreatment scoring system, immune-related histologic phenotype assessment criteria (irHPC). Three trained pathologists independently scored the haematoxylin-eosin (HE) slides of the pretreatment tumour biopsies according to irHPC. The follow-up was from 07 March 2018 to 31 December 2021, mainly focusing on disease-free survival (DFS) and overall survival (OS). Second, 109 biopsies of lung squamous cell carcinoma were evaluated to explore the relationship between eosinophils and PD-L1 expression.ResultsSuperior 2-year DFS rates and 2-year OS rates were observed in patients who achieved major pathologic response (MPR) (MPR vs. non-MPR: 92.9% vs. 78.6%; 100.0% vs. 93.3%). Whether necrosis was included in the calculation of the per cent of residual viable tumour (%RVT) or not had almost no effect on the consistency of pathologic assessment and the histological response grouping. The interpathologist variability in assessing %RVT with immune-activated phenotype was not statistically significant (P = 0.480). Four immune-related features of pretreatment biopsies were included for calculating the predictive score. The trained pathologist accurately predicted most cases according to irHPC. For interobserver reproducibility using “2 points” as the cutoff, the overall per cent agreement was 77.8%. The reliability between pathologists for a binary tumour evaluation showed “moderate” agreement (κ = 0.54). Patients with scores ≥ 2 points tended to have better 2-year DFS rates and 2-year OS rates than those with scores < 2 points (85.7% vs. 71.4%; 100.0% vs. 87.5%).ConclusionsThe irHPC scoring system reflecting the preexisting immune response could be used to predict pathologic response to neoadjuvant immunotherapy, possibly further predicting the long-term prognosis, but larger trials are needed for verification.