ArticleLaboratory medicine2026
HScore as a diagnostic tool in ERBB2 equivocal (immunohistochemistry 2+) breast cancer.
Article in Laboratory medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionERBB2 is amplified or overexpressed in 15% to 20% of primary invasive breast cancers. Despite the aggressive nature of ERBB2-positive breast cancers, the development of anti-ERBB2 therapy has resulted in better prognoses. HScore is a scoring system that broadens immunohistochemistry (IHC) results into a quantitative range. The aim of this retrospective study was to evaluate whether the HScore can be used to predict all ERBB2 IHC-equivocal cases as positive or negative without the need for fluorescence in situ hybridization confirmation.
methodsImage acquisition and processing tools were used on previously collected tissue slides from patients with ERBB2 IHC 2+ breast cancer from 2014 to 2023. After image acquisition, HScore values were calculated using variables from image analysis software.
resultsThe mean HScore values in ERBB2-positive cases were higher (3.06) than in ERBB2-negative cases (2.62). Receiver operating characteristic curve analysis yielded an area under the curve of 0.668 (95% CI, 0.523-0.812), indicating poor predictive accuracy. The optimal HScore cutoff of 2.6007 provided moderate sensitivity (0.77) but limited specificity (0.58). DISCUSSION: Although the HScore showed moderate predictive accuracy, it lacked the reliability to replace fluorescence in situ hybridization as the gold standard. Future research should focus on refining the methodology and integrating it with other diagnostic approaches to enhance accuracy and clinical utility.
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