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基于弱监督深度学习的宫颈腺癌 Silva 分型的组织病理图像分析

A Histopathologic Image Analysis for the Classification of Endocervical Adenocarcinoma Silva Patterns Depend on Weakly Supervised Deep Learning.

机构信息

Cheeloo College of Medicine, Shandong University, Jinan City, China.

Department of Pathology, School of Basic Medical Sciences and Qilu Hospital, Shandong University, Jinan City, China.

出版信息

Am J Pathol. 2024 May;194(5):735-746. doi: 10.1016/j.ajpath.2024.01.016. Epub 2024 Feb 19.

Abstract

Twenty-five percent of cervical cancers are classified as endocervical adenocarcinomas (EACs), which comprise a highly heterogeneous group of tumors. A histopathologic risk stratification system known as the Silva pattern system was developed based on morphology. However, accurately classifying such patterns can be challenging. The study objective was to develop a deep learning pipeline (Silva3-AI) that automatically analyzes whole slide image-based histopathologic images and identifies Silva patterns with high accuracy. Initially, a total of 202 patients with EACs and histopathologic slides were obtained from Qilu Hospital of Shandong University for developing and internally testing the Silva3-AI model. Subsequently, an additional 161 patients and slides were collected from seven other medical centers for independent testing. The Silva3-AI model was developed using a vision transformer and recurrent neural network architecture, utilizing multi-magnification patches, and its performance was evaluated based on a class-specific area under the receiver-operating characteristic curve. Silva3-AI achieved a class-specific area under the receiver-operating characteristic curve of 0.947 for Silva A, 0.908 for Silva B, and 0.947 for Silva C on the independent test set. Notably, the performance of Silva3-AI was consistent with that of professional pathologists with 10 years' diagnostic experience. Furthermore, the visualization of prediction heatmaps facilitated the identification of tumor microenvironment heterogeneity, which is known to contribute to variations in Silva patterns.

摘要

25%的宫颈癌被归类为宫颈内膜腺癌(EAC),它包含一组高度异质的肿瘤。一种基于形态学的组织病理学风险分层系统——Silva 模式系统被开发出来。然而,准确地对这些模式进行分类可能具有挑战性。本研究的目的是开发一种深度学习管道(Silva3-AI),该管道能够自动分析基于全切片图像的组织病理学图像,并以高精度识别 Silva 模式。最初,从山东大学齐鲁医院获得了总共 202 例 EAC 患者和组织病理学切片,用于开发和内部测试 Silva3-AI 模型。随后,从其他 7 个医疗中心收集了另外 161 例患者和切片进行独立测试。Silva3-AI 模型采用视觉转换器和递归神经网络架构开发,利用多放大补丁,并根据接收器操作特征曲线下的特定类别面积评估其性能。Silva3-AI 在独立测试集上对 Silva A、Silva B 和 Silva C 的接收器操作特征曲线下的特定类别面积的得分分别为 0.947、0.908 和 0.947。值得注意的是,Silva3-AI 的性能与具有 10 年诊断经验的专业病理学家一致。此外,预测热图的可视化有助于识别肿瘤微环境异质性,这已知会导致 Silva 模式的变化。

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