Assessment of PD-L1 expression and tumour infiltrating lymphocytes in early-stage non-small cell lung carcinoma with artificial intelligence algorithms

Molero, AidaHernández, SusanaAlonso, MartaPeressini, MelinaCurto, DanielLópez-Ríos Moreno, FernandoConde, Esther2025-02-192025-02-192024-10-17Molero A, Hernandez S, Alonso M, et al. J Clin Pathol Epub ahead of print: [please include Day Month Year]. doi:10.1136/ jcp-2024-2097660021-974610.1136/jcp-2024-209766https://hdl.handle.net/20.500.14352/118190Fondos FEDERAims: To study programmed death ligand 1 (PD-L1) expression and tumour infiltrating lymphocytes (TILs) in patients with early-stage non-small cell lung carcinoma (NSCLC) with artificial intelligence (AI) algorithms. Methods: The study included samples from 50 early-stage NSCLCs. PD-L1 immunohistochemistry (IHC) stained slides (clone SP263) were scored manually and with two different AI tools (PathAI and Navify Digital Pathology) by three pathologists. TILs were digitally assessed on H&E and CD8 IHC stained sections with two different algorithms (PathAI and Navify Digital Pathology, respectively). The agreement between observers and methods for each biomarker was analysed. For PD-L1, the turn-around time (TAT) for manual versus AI-assisted scoring was recorded. Results: Agreement was higher in tumours with low PD-L1 expression regardless of the approach. Both AI-powered tools identified a significantly higher number of cases equal or above 1% PD-L1 tumour proportion score as compared with manual scoring (p=0.00015), a finding with potential therapeutic implications. Regarding TAT, there were significant differences between manual scoring and AI use (p value <0.0001 for all comparisons). The total TILs density with the PathAI algorithm and the total density of CD8+ cells with the Navify Digital Pathology software were significantly correlated (τ=0.49 (95% CI 0.37, 0.61), p value<0.0001). Conclusions: This preliminary study supports the use of AI algorithms for the scoring of PD-L1 and TILs in patients with NSCLC.engAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Assessment of PD-L1 expression and tumour infiltrating lymphocytes in early-stage non-small cell lung carcinoma with artificial intelligence algorithmsjournal article1472-4146https://doi.org/10.1136/jcp-2024-20976639419594https://jcp.bmj.com/content/early/2024/10/17/jcp-2024-209766.longhttps://pubmed.ncbi.nlm.nih.gov/39419594/open access616.1/.9Artificial IntelligenceBiomarkersTumorLung NeoplasmsCiencias Biomédicas32 Ciencias Médicas3207 Patología