arXiv:2604.22846cs.CV2026-04

用少量病理标注统一多模型幻灯片表示,实现跨癌种识别与文本定位。

Unified Multi-Foundation-Model Slide Representation for Pan-Cancer Recognition and Text-Guided Tumor Localization

论文配图:Unified Multi-Foundation-Model Slide Representation for Pan-Cancer Recognition and Text-Guided Tumor Localization
图 1 · 摘自论文原文
  • 融合异构模型特征,通过结构化标注构建统一幻灯片表征空间。
  • 4类分类宏AUC达97.8%,16类癌症分类准确率99.2%,肿瘤定位Dice达0.897。
  • 仅需幻灯片级元数据,即可支持跨癌种预测与弱监督定位,适合临床部署。

病理基础模型生态日益丰富,但其局部切片表示分散,难以支持需要统一幻灯片级推理和可解释关联的临床任务。本文提出ASTRA框架,将异构基础模型表示整合至共享的幻灯片级表征空间,并利用结构化病理标注(包括分类类别、癌种、解剖部位)进行语义锚定。ASTRA结合稀疏专家混合上下文建模、掩码多模态重建和对比对齐结构化病理提示,学习支持四类分类、三类实体瘤分型、十六类癌种分型及文本引导肿瘤定位的幻灯片表示,无需像素级标注。该框架基于包含10,359张全幻灯片图像(WSIs)的CHTN队列(覆盖16种肿瘤类型),在四种病理基础模型主干上均实现性能提升:四类分类宏AUC最高达97.8%,三类实体瘤分型达99.7%,十六类癌种分型达99.2%。在肿瘤定位方面,于内部标注的CHTN子集(n=380,覆盖16种癌种)上平均Dice为0.897,在外部TCGA队列(n=1,686,覆盖4种癌种)上为0.738。结果表明,仅需从幻灯片级元数据中提取的少量结构化标注,即可为统一幻灯片表征学习提供有效语义监督,实现在单一框架内完成跨癌种预测与弱监督肿瘤定位。

原文摘要 · Abstract (English)

The expanding ecosystem of pathology foundation models has produced powerful but fragmented tile-level representations, limiting their use in clinical tasks that require unified slide-level reasoning and interpretable linkage to clinically meaningful information. We present ASTRA, a pan-cancer framework that integrates heterogeneous foundation-model representations into a shared slide-level representation space and semantically grounds that space using structured pathology annotation fields, including classification category, cancer type, and anatomic site. ASTRA combines sparse mixture-of-experts contextualization, masked multi-model reconstruction, and contrastive alignment to structured pathology prompts to learn slide representations that support 4-category classification, 3-class solid tumor typing, 16-class cancer typing, and text-guided tumor localization without pixel-level supervision. Developed on a CHTN cohort of 10,359 whole-slide images (WSIs) spanning 16 tumor types, ASTRA consistently improves pan-cancer classification across four pathology foundation-model backbones, achieving up to 97.8% macro-AUC for 4-category classification, 99.7% for 3-class solid tumor typing, and 99.2% for 16-class cancer typing. For tumor localization, ASTRA achieves a mean Dice of 0.897 on an annotated in-domain CHTN subset (n = 380) spanning 16 cancer types and 0.738 on an external TCGA cohort (n = 1,686) spanning four cancer types. These results demonstrate that minimal structured pathology annotation fields derived from slide-level metadata can provide effective semantic supervision for unified slide representation learning, enabling both pan-cancer prediction and weakly supervised tumor localization within a single framework.

病理分析多模型融合跨癌种识别弱监督定位

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