{
  "abstract": "Programmed death-ligand 1 (PD-L1) is a predictive biomarker in various cancers. In colorectal cancer, PD-L1 expression evaluation is not part of the routine examination and standardized evaluation methods are lacking. This study aimed to examine inter-rater agreement in PD-L1 expression evaluation in patients with colon cancer (CC) using different manual scoring methods, and to compare the manual methods to a digital evaluation. Two pathologists evaluated 188 PD-L1-stained slides from patients with CC. The tumor proportion score (TPS) and immune cell score (ICS) were categorized as <1%, 1-9%, and ≥10% positivity and the combined positive score (CPS) as <1, 1-9, and ≥10 positivity. Inter-rater agreement was assessed using different cutoffs and consensus scores were compared with an in-house-developed digital algorithm quantifying PD-L1. Percentage agreement was 98.9% for TPS, 85.6% for ICS, and 88.8% for CPS. When dichotomized using 1% or 10% for ICS and 1 or 10 for CPS as cutoffs, the percentage agreement increased. Only 2 cases presented with a consensus TPS ≥1%, while 96.8% had a consensus ICS of <10%, and 98.4% a consensus CPS of <10. When the digital PD-L1 score was categorized into low and high, the highest agreement with the manual evaluations was reached using the third quartile as a cutoff. Conclusively, high inter-rater percentage agreements were obtained for all scoring methods, although kappa values varied. Results comparable to the manual evaluation were reached with a digital algorithm. A digital approach can potentially eliminate inter-rater variability. Clinically relevant cutoff values remain to be determined.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Zealand University Hospital, Roskilde",
    "Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge",
    "Department of Pathology, Rigshospitalet, Copenhagen",
    "Visiopharm A/S, Hoersholm",
    "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Dea N.M. Jepsen",
      "orcid": "0000-0001-7561-6350"
    },
    {
      "affs": [
        0
      ],
      "name": "Marianne B. Jensen"
    },
    {
      "affs": [
        2
      ],
      "name": "Trine L. Grantzau"
    },
    {
      "affs": [
        1
      ],
      "name": "Astrid L.B. Bennedsen"
    },
    {
      "affs": [
        3
      ],
      "name": "Thomas T. Eriksen"
    },
    {
      "affs": [
        0
      ],
      "name": "Michael Bzorek"
    },
    {
      "affs": [
        1,
        4
      ],
      "name": "Ismail Gögenur"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Anne-Marie K. Fiehn"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bb35wkexrwq59.bib",
  "cited_by": 0,
  "doi": "10.1097/pai.0000000000001345",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730305/",
  "id": "bb35wkexrwq59",
  "issns": [
    "1541-2016",
    "1533-4058"
  ],
  "landing_url": "https://doi.org/10.1097/pai.0000000000001345",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Articles"
    ],
    [
      "openalex",
      "2730|Cancer Immunotherapy and Biomarkers"
    ]
  ],
  "openalex": "W7203602358",
  "pdf_url": null,
  "pmcid": "PMC13730305",
  "pmid": "42606343",
  "published": "2026-08-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bb35wkexrwq59.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:53Z",
      "native_id": "PMC13730305",
      "source": "pmc",
      "url": "https://doi.org/10.1097/pai.0000000000001345"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer Immunotherapy and Biomarkers",
      "subfield": "oncology"
    }
  ],
  "title": "Inter-Rater Agreement in PD-L1 (22C3) Expression Evaluation in Colon Cancer",
  "title_text": "Inter-Rater Agreement in PD-L1 (22C3) Expression Evaluation in Colon Cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:53Z",
  "url": "https://research.draconitic.com/paper/bb35wkexrwq59",
  "venue": "Applied Immunohistochemistry & Molecular Morphology",
  "versions": []
}