Aalam Syed Wajid, Ahanger Abdul Basit, Majeed Tabasum, Ahanger Ab Naffi, Masoodi Tariq, Bhat Ajaz A, Assad Assif, Macha Muzafar Ahmad, Bhat Muzafar Rasool
Department of Computer Science, Islamic University of Science and Technology (IUST), Awantipora, Kashmir, India.
Centre for Artificial Intelligence, Islamic University of Science and Technology, Awantipora, Kashmir, India.
J Transl Med. 2025 Aug 21;23(1):945. doi: 10.1186/s12967-025-06914-4.
BACKGROUND: Despite recent advancements in the diagnosis and prognosis of Esophageal cancer (EC), it remains among the leading causes of cancer-related mortality. Timely and cost-effective diagnosis, particularly in predicting the risk of metastasis and identifying the deregulation of oncogenic signaling pathways, could open new frontiers towards precision medicine and targeted therapy of EC. However, current diagnostic practices in identifying metastasis and deregulated oncogenic pathways involve molecular testing, which is time-consuming and costly. Advances in deep learning analysis of digital pathological imagery data offer promising avenues for automating and enhancing cancer diagnosis and risk stratification. METHODS: High-resolution H&E-stained diagnostic whole slide images were obtained from the open repository of The Cancer Genome Atlas (TCGA). The WSIs underwent several pre-processing steps, including patching, color normalization and augmentation. A deep learning model was designed and trained on WSI data and tissue-level labels to generate image feature representations for predicting metastatic potential and identifying the deregulation of four major oncogenic signaling pathways, viz. mTOR, PTEN, p53, and PI3K/AKT. RESULTS: The proposed model achieved an AUC of 0.92 for predicting metastatic risk and AUCs ranging from 0.64 to 0.92 for the identification of deregulated oncogenic pathways. In a first, we were able to operate the model without the need for exhaustive patch-level annotations, relying instead on slide-level annotations only. CONCLUSION: In this work, we highlighted the transformative potential of deep learning in accurately detecting metastasis and identifying deregulated oncogenic pathways from H&E slides using slide-level annotation, thus opening new doors in precision medicine and targeted therapy.
背景:尽管食管癌(EC)的诊断和预后方面最近取得了进展,但它仍然是癌症相关死亡的主要原因之一。及时且具有成本效益的诊断,特别是在预测转移风险和识别致癌信号通路失调方面,可能为EC的精准医学和靶向治疗开辟新的途径。然而,目前识别转移和失调致癌途径的诊断方法涉及分子检测,既耗时又昂贵。数字病理图像数据的深度学习分析进展为自动化和加强癌症诊断及风险分层提供了有前景的途径。 方法:从癌症基因组图谱(TCGA)的开放数据库中获取高分辨率苏木精-伊红(H&E)染色的诊断全切片图像。对全切片图像进行了几个预处理步骤,包括分块、颜色归一化和增强。设计并训练了一个深度学习模型,该模型基于全切片图像数据和组织水平标签生成图像特征表示,以预测转移潜力并识别四种主要致癌信号通路,即mTOR、PTEN、p53和PI3K/AKT的失调。 结果:所提出的模型在预测转移风险方面的曲线下面积(AUC)为0.92,在识别失调致癌途径方面的AUC范围为0.64至0.92。首先,我们能够仅依靠玻片水平注释来运行该模型,而无需详尽的斑块水平注释。 结论:在这项工作中,我们强调了深度学习在使用玻片水平注释从H&E切片中准确检测转移和识别失调致癌途径方面的变革潜力,从而为精准医学和靶向治疗打开了新的大门。
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