arXiv:2409.15491eess.IVcs.AI2024-09被引 10

用普通病理切片预测乳腺癌复发风险,比现有方法更准更便宜。

Computational Pathology for Accurate Prediction of Breast Cancer Recurrence: Development and Validation of a Deep Learning-based Tool

  • 基于H&E染色全片图像,用深度学习模型自动分析复发风险。
  • 在两个独立数据集上,准确率超82%,曲线下面积达0.83。
  • 适合临床推广,尤其为资源不足地区提供低成本精准评估方案。

准确的复发风险分层对优化乳腺癌治疗方案至关重要。现有工具如Oncotype DX(ODX)虽能提供基因组信息,但受限于成本与可及性,尤其在弱势人群中难以普及。本研究提出Deep-BCR-Auto,一种基于深度学习的计算病理方法,可从常规H&E染色全片图像(WSIs)中预测乳腺癌复发风险。该方法在TCGA-BRCA数据集和俄亥俄州立大学(OSU)自建数据集上均得到验证。在TCGA-BRCA数据集上,模型的受试者工作特征曲线下面积(AUROC)达0.827,显著优于现有弱监督模型(p=0.041)。在独立的OSU数据集中,模型保持良好泛化能力,实现AUROC 0.832,准确率82.0%,特异性85.0%,敏感度67.7%。结果表明,计算病理可作为复发风险评估的经济高效替代方案,扩大个性化治疗策略的可及性。本研究强调将深度学习驱动的计算病理整合至常规病理评估中,具有跨多种临床环境的实用价值。

原文摘要 · Abstract (English)

Accurate recurrence risk stratification is crucial for optimizing treatment plans for breast cancer patients. Current prognostic tools like Oncotype DX (ODX) offer valuable genomic insights for HR+/HER2- patients but are limited by cost and accessibility, particularly in underserved populations. In this study, we present Deep-BCR-Auto, a deep learning-based computational pathology approach that predicts breast cancer recurrence risk from routine H&E-stained whole slide images (WSIs). Our methodology was validated on two independent cohorts: the TCGA-BRCA dataset and an in-house dataset from The Ohio State University (OSU). Deep-BCR-Auto demonstrated robust performance in stratifying patients into low- and high-recurrence risk categories. On the TCGA-BRCA dataset, the model achieved an area under the receiver operating characteristic curve (AUROC) of 0.827, significantly outperforming existing weakly supervised models (p=0.041). In the independent OSU dataset, Deep-BCR-Auto maintained strong generalizability, achieving an AUROC of 0.832, along with 82.0% accuracy, 85.0% specificity, and 67.7% sensitivity. These findings highlight the potential of computational pathology as a cost-effective alternative for recurrence risk assessment, broadening access to personalized treatment strategies. This study underscores the clinical utility of integrating deep learning-based computational pathology into routine pathological assessment for breast cancer prognosis across diverse clinical settings.

计算病理乳腺癌深度学习复发预测

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