Head and neck squamous cell carcinomas (HNSCCs) have poor clinical outcome owing to therapy resistance and frequent recurrences that are among others attributable to tumor cells in partial epithelial-to-mesenchymal transition (pEMT). We compared side-by-side software-based and visual quantification of immunohistochemistry (IHC) staining of epithelial marker EpCAM and EMT regulator Slug in n = 102 primary HNSCC to assess optimal analysis protocols. IHC scores incorporated expression levels and percentages of positive cells. Digital and visual evaluation of membrane-associated EpCAM yielded correlating scorings, whereas visual evaluation of nuclear Slug resulted in significantly higher overall scores. Multivariable Cox proportional hazard analysis defined the median EpCAM expression levels resulting from visual quantification as an independent prognostic factor of overall survival. Slug expression levels resulting from digital quantification were an independent prognostic factor of recurrence-free survival, locoregional recurrence-free survival, and disease-specific survival. Hence, we propose to use visual assessment for the membrane-associated EpCAM protein, whereas nuclear protein Slug assessment was more accurate following digital measurement.

中文翻译：

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EpCAM 和 slug 表达的数字评分作为头颈部鳞状细胞癌的预后标志物。

头颈部鳞状细胞癌 (HNSCC) 的临床结果较差，原因是治疗抵抗和频繁复发，其中包括部分上皮间质转化 (pEMT) 中的肿瘤细胞。我们比较了 n = 102 原发性 HNSCC 中上皮标志物 EpCAM 和 EMT 调节剂 Slug 的免疫组织化学 (IHC) 染色的基于软件和视觉量化，以评估最佳分析方案。IHC 评分结合了阳性细胞的表达水平和百分比。膜相关 EpCAM 的数字和视觉评估产生相关评分，而核 Slug 的视觉评估导致显着更高的总体评分。多变量 Cox 比例风险分析将视觉量化产生的中值 EpCAM 表达水平定义为总体存活的独立预后因素。数字量化产生的 Slug 表达水平是无复发生存、局部无复发生存和疾病特异性生存的独立预后因素。因此，我们建议对膜相关的 EpCAM 蛋白使用视觉评估，而核蛋白 Slug 评估在数字测量后更准确。