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LeChat in oral pathology: Assessment of its immunohistochemical marker selection accuracy in salivary gland tumors

Title: LeChat in oral pathology: Assessment of its immunohistochemical marker selection accuracy in salivary gland tumors
Authors: Maria Cuevas-Nunez; Cosimo Galletti; Javier Flores-Fraile; Shokoufeh Shahrabi Farahani; Wilmer Rodrigo Díaz-Castañeda; Daniele Portelli; Luca Fiorillo; Vini Mehta; Maria-Teresa Fernández-Figueras
Source: Oral Oncology Reports, Vol 17, Iss , Pp 100781- (2026)
Publisher Information: Elsevier, 2026.
Publication Year: 2026
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Artificial intelligence; LeChat; Immunohistochemistry; Salivary gland tumors; Pathology; Large language models; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282
Description: Background: Artificial intelligence (AI) is increasingly integrated into pathology, but its accuracy in immunohistochemical (IHC) marker selection remains underexplored. This study evaluated LeChat's ability to recommend IHC markers for benign and malignant salivary gland tumors, focusing on accuracy, completeness, relevance, consistency, and marker-level errors across tumor types and subtypes. Methods: A total of 21 tumor types were selected and classified by behavior (benign vs. malignant) and histologic subtype. Expert-derived reference panels served as the gold standard. For each tumor, LeChat was queried three times using standardized prompts. Recommendations were scored across three domains: accuracy (inclusion of essential markers), completeness (inclusion of secondary markers), and relevance (absence of irrelevant markers). Composite scores (range: 3–9) and intra-tumor variability were calculated. Mann–Whitney U and Kruskal–Wallis tests assessed differences by tumor category and subtype. Marker-level analysis evaluated over- and under-recommendations. Results: Across 63 total prompts, LeChat achieved a mean accuracy of 1.56, completeness of 1.59, and relevance of 2.35. Only 3.2 % of prompts included all essential markers, and 17.5 % achieved composite scores ≥7. No responses included both primary and secondary markers. Performance did not differ significantly between benign and malignant tumors (p = 0.405), nor across histologic subtypes (p = 0.988). Tumor-level variability was highest for basaloid squamous cell carcinoma and lowest for pleomorphic adenoma. Marker-level analysis identified 14 false positives (e.g., CD20, IgG4) and 9 false negatives (e.g., SOX10, β-catenin). A moderate correlation was observed between marker frequency and accuracy (r = 0.48, p
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2772-9060
Relation: http://www.sciencedirect.com/science/article/pii/S2772906025000718; https://doaj.org/toc/2772-9060
DOI: 10.1016/j.oor.2025.100781
Access URL: https://doaj.org/article/2da342da763b4e2987f43fa51d369cd5
Accession Number: edsdoj.2da342da763b4e2987f43fa51d369cd5
Database: Directory of Open Access Journals