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        <datestamp>2026-09-29T05:46:22Z</datestamp>
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          <dc:title>Table 2_Automatic grading of HER2 immunohistochemical whole-slide images based on a multi-scale hierarchical graph neural network.docx</dc:title>
          <dc:creator>Yingjie Jiang (4473253)</dc:creator>
          <dc:creator>Wenhao Sun (3201390)</dc:creator>
          <dc:creator>Chao Ye (765248)</dc:creator>
          <dc:creator>Chun Xu (286394)</dc:creator>
          <dc:creator>Jiewen Xue (25135533)</dc:creator>
          <dc:creator>Yiliang Wang (1272954)</dc:creator>
          <dc:creator>Shiju Yan (25135536)</dc:creator>
          <dc:creator>Yiming Li (40290)</dc:creator>
          <dc:creator>Chenguang Bai (13951266)</dc:creator>
          <dc:subject>Public Health and Health Services not elsewhere classified</dc:subject>
          <dc:subject>artificial intelligence</dc:subject>
          <dc:subject>automated HER2 grading</dc:subject>
          <dc:subject>breast cancer</dc:subject>
          <dc:subject>graph neural network</dc:subject>
          <dc:subject>HER2 immunohistochemistry</dc:subject>
          <dc:subject>whole-slide imaging</dc:subject>
          <dc:description>Objective&lt;p&gt;The HER2 immunohistochemical (IHC) score of breast cancer is a critical precursor for determining eligibility for anti-HER2 targeted therapy, as the final HER2 status (positive/negative/low) is determined by IHC results combined with FISH confirmation for equivocal 2 + cases according to ASCO/CAP guidelines. However, most existing artificial intelligence methods separate the detection of invasive cancer regions from HER2 grading and fail to adequately model the spatial heterogeneity of whole-slide tumors. This study proposes an end-to-end intelligent HER2 grading framework that integrates automated detection of invasive cancer regions with hierarchical graph reasoning, enabling automated and precise evaluation of HER2 IHC in breast cancer.&lt;/p&gt;Method&lt;p&gt;A coarse-to-fine automated HER2 grading framework was developed. First, invasive tumor regions were automatically identified through supervised multi-scale tissue segmentation. Within the detected regions, patch-level HER2 grading integrates Delaunay cell image features with self-supervised visual representations, while WSI-level spatial representations model tumor heterogeneity to achieve fully automated HER2 grading across whole-slide images. The framework was trained using data from two scanning platforms and externally validated on 82 independent WSI samples from a third platform.&lt;/p&gt;Results&lt;p&gt;In independent external validation, the Dice coefficient for invasive region detection reached 0.89 (on 50 WSI images); the accuracy rate of HER2 grading at the patch level was 96.49% (95% CI, 96.08–96.87%) (7,924 patches), while that at the WSI level reached 98.0% (95% CI, 91.5–99.9%) (82 WSI images). The quadratic-weighted Cohen’s κ was 0.97 (95% CI, 0.94–1.00), and all misclassifications at the WSI level were confined to the distinction between HER2 1 + and 2 +.&lt;/p&gt;Conclusion&lt;p&gt;This framework enables fully automated HER2 IHC scoring and interpretation under multicenter and cross-scanner conditions, providing a computational tool for standardized IHC assessment, while final HER2 status determination for 2 + cases still requires FISH validation.&lt;/p&gt;</dc:description>
          <dc:date>2026-09-29T05:46:22Z</dc:date>
          <dc:type>Dataset</dc:type>
          <dc:type>Dataset</dc:type>
          <dc:identifier>10.3389/fpubh.2026.1940487.s001</dc:identifier>
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          <dc:rights>CC BY 4.0</dc:rights>
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