Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Br J Haematol. 2023 Nov;203(4):523-535. doi: 10.1111/bjh.19154. Epub 2023 Oct 19.
The diagnosis of myeloproliferative neoplasms (MPN) requires the integration of clinical, morphological, genetic and immunophenotypic findings. Recently, there has been a transformation in our understanding of the cellular and molecular mechanisms underlying disease initiation and progression in MPN. This has been accompanied by the widespread application of high-resolution quantitative molecular techniques. By contrast, microscopic interpretation of bone marrow biopsies by haematologists/haematopathologists remains subjective and qualitative. However, advances in tissue image analysis and artificial intelligence (AI) promise to transform haematopathology. Pioneering studies in bone marrow image analysis offer to refine our understanding of the boundaries between reactive samples and MPN subtypes and better capture the morphological correlates of high-risk disease. They also demonstrate potential to improve the evaluation of current and novel therapeutics for MPN and other blood cancers. With increased therapeutic targeting of diverse molecular, cellular and extra-cellular components of the marrow, these approaches can address the unmet need for improved objective and quantitative measures of disease modification in the context of clinical trials. This review focuses on the state-of-the-art in image analysis/AI of bone marrow tissue, with an emphasis on its potential to complement and inform future clinical studies and research in MPN.
骨髓增生性肿瘤（MPN）的诊断需要整合临床、形态学、遗传学和免疫表型发现。最近，我们对疾病起始和进展的细胞和分子机制的理解发生了转变。这伴随着高通量定量分子技术的广泛应用。相比之下，血液学家/血液病理学家对骨髓活检的显微镜解释仍然是主观和定性的。然而，组织图像分析和人工智能（AI）的进步有望改变血液病理学。骨髓图像分析的开创性研究有望深化我们对反应性样本和 MPN 亚型之间界限的理解，并更好地捕捉高危疾病的形态学相关性。它们还展示了在 MPN 和其他血液癌的当前和新型治疗药物评估方面的潜力。随着对骨髓中不同分子、细胞和细胞外成分的治疗靶向增加，这些方法可以满足在临床试验中改进疾病改善的客观和定量测量的未满足需求。本综述重点介绍了骨髓组织图像分析/AI 的最新技术，强调了其在补充和告知未来 MPN 临床研究和研究方面的潜力。
