arXiv:2603.20273cs.CVcs.AI2026-03

用AI分析多切片病理图像,精准预测前列腺癌术后复发风险。

Efficient AI-Driven Multi-Section Whole Slide Image Analysis for Biochemical Recurrence Prediction in Prostate Cancer

  • 同时处理多个病理切片,全面捕捉肿瘤分布特征。
  • 在789例患者数据上,1年和2年复发预测准确率显著优于传统指标。
  • 计算成本低且可外推,适合临床规模化应用。

前列腺癌是全球男性中最常见的恶性肿瘤之一。然而,由于肿瘤在前列腺腺体中多灶性分布,根治性前列腺切除术后生化复发(BCR)的精准预测仍具挑战。本文提出一种新型AI框架,可同时处理一系列多切片病理图像,以捕捉整个前列腺腺体中的肿瘤全景。为构建该预测模型,我们整理了来自789名患者的23,451张病理切片的大型数据集。所提框架在1年和2年BCR预测上表现出色,显著优于现有临床基准。基于AI的风险评分在多变量Cox比例风险分析中被验证为最强独立预后因子,超越传统的临床指标如术前PSA和格里森评分。此外,我们证明了融合块级与切片子采样策略能大幅降低训练与推理时的计算开销,且不损害预测性能,外部验证证实了AI模型的泛化能力。总体而言,这些结果表明,基于AI的多切片图像分析具有临床可行性与预后价值,是一种可扩展的术后管理工具。

原文摘要 · Abstract (English)

Prostate cancer is one of the most frequently diagnosed malignancies in men worldwide. However, precise prediction of biochemical recurrence (BCR) after radical prostatectomy remains challenging due to the multifocality of tumors distributed throughout the prostate gland. In this paper, we propose a novel AI framework that simultaneously processes a series of multi-section pathology slides to capture the comprehensive tumor landscape across the entire prostate gland. To develop this predictive AI model, we curated a large-scale dataset of 23,451 slides from 789 patients. The proposed framework demonstrated strong predictive performance for 1- and 2-year BCR prediction, substantially outperforming established clinical benchmarks. The AI-derived risk score was validated as the most potent independent prognostic factor in a multivariable Cox proportional hazards analysis, surpassing conventional clinical markers such as pre-operative PSA and Gleason score. Furthermore, we demonstrated that integrating patch and slide sub-sampling strategies significantly reduces computational cost during both training and inference without compromising predictive performance, and generalizability of AI was confirmed through external validation. Collectively, these results highlight the clinical feasibility and prognostic value of the proposed AI-based multi-section slide analysis as a scalable tool for post-operative management in prostate cancer.

前列腺癌病理分析AI预测多切片

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