Sobral-Leite Marcelo, Castillo Simon P, Vonk Shiva, Messal Hendrik A, Melillo Xenia, Lam Noomie, de Bruijn Brandi, Hagos Yeman B, van den Bos Myrna, Sanders Joyce, Almekinders Mathilde, Visser Lindy L, Groen Emma J, Kristel Petra, Ercan Caner, Azarang Leyla, van Rheenen Jacco, Hwang E Shelley, Yuan Yinyin, Menezes Renee, Lips Esther H, Wesseling Jelle
Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Division of Pathology and Laboratory Medicine, Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
NPJ Precis Oncol. 2025 Jan 28;9(1):25. doi: 10.1038/s41698-024-00769-6.
Ductal carcinoma in situ (DCIS) may progress to ipsilateral invasive breast cancer (iIBC), but often never will. Because DCIS is treated as early breast cancer, many women with harmless DCIS face overtreatment. To identify features associated with progression, we developed an artificial intelligence-based DCIS morphometric analysis pipeline (AIDmap) on hematoxylin-eosin-stained (H&E) tissue sections. We analyzed 689 digitized H&Es of pure primary DCIS of which 226 were diagnosed with subsequent iIBC and 463 were not. The distribution of 15 duct morphological measurements was summarized in 55 morphometric variables. A ridge regression classifier with cross validation predicted 5-years-free of iIBC with an area-under the curve of 0.67 (95% CI 0.57-0.77). A combined clinical-morphometric signature, characterized by small-sized ducts, a low number of cells and a low DCIS/stroma ratio, was associated with outcome (HR = 0.56; 95% CI 0.28-0.78). AIDmap has potential to identify harmless DCIS that may not need treatment.
导管原位癌（DCIS）可能会进展为同侧浸润性乳腺癌（iIBC），但通常不会。由于DCIS被视为早期乳腺癌，许多患有无害DCIS的女性面临过度治疗。为了识别与进展相关的特征，我们在苏木精-伊红染色（H&E）的组织切片上开发了一种基于人工智能的DCIS形态计量分析流程（AIDmap）。我们分析了689例纯原发性DCIS的数字化H&E切片，其中226例随后被诊断为iIBC，463例未被诊断为iIBC。15个导管形态测量值的分布总结在55个形态计量变量中。采用交叉验证的岭回归分类器预测无iIBC的5年生存率，曲线下面积为0.67（95%CI 0.57-0.77）。一种以小导管、低细胞数和低DCIS/基质比为特征的临床-形态计量联合特征与预后相关（HR = 0.56；95%CI 0.28-0.78）。AIDmap有潜力识别可能不需要治疗的无害DCIS。
