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Eur Urol Focus:前列腺癌苏木精和伊红图像中计算得出的筛状面积指数与前列腺根治术后的生化复发有关

2021-05-31 AlexYang MedSci原创

前列腺癌侵袭性的评估是基于几个临床因素,包括肿瘤分期、前列腺特异性抗原(PSA)水平和通过格里森分级评估的组织形态。利用格里森分级系统,病理学家将肿瘤组织中的所有形态学模式分为五种模式,根治性前列腺切

前列腺癌侵袭性的评估是基于几个临床因素,包括肿瘤分期、前列腺特异性抗原(PSA)水平和通过格里森分级评估的组织形态。利用格里森分级系统,病理学家将肿瘤组织中的所有形态学模式分为五种模式,根治性前列腺切除术(RP)标本的格里森评分是两种最常见模式的总和。

在根治性前列腺切除术(RP)标本中,侵袭性筛状腺癌(ICC)的存在与生化复发(BCR)相关,ICC是一种细胞扩张,包含不间断间质的穿孔腔。然而,ICC的鉴定在审查者之间只有一定程度的一致性。

近期,有研究人员定量评估了ICC的范围和预后效用,特别是在各个格里森等级组内进行了评估

研究人员利用70名RP患者开发了一种机器学习方法来进行ICC的分析,并在4个地点的749名患者中进行了验证。这些患者的手术年份中位数为2007年,随访时间中位数为28个月。研究人员在每个患者的其中一张具有代表性的苏木精和伊红RP切片上对ICC进行分割,并测量了由ICC组成的肿瘤面积比例,即筛状区域指数(CAI)。研究人员通过一致性指数(c指数)和风险比(HR)衡量了CAI和BCR之间的相关性。

结果发现,在411名具有ICC形态特征的验证组中,CAI与BCR存在相关性(c指数为0.62),那些格林森2级的癌症患者(n=192;c指数为0.66)相关性更强。而当患者的ICC没有纳入时,其预后性能较差(c指数为0.54)。在控制了Gleason等级、手术边缘阳性、术前前列腺特异性抗原水平、病理T期和年龄后,具有ICC形态特征患者加倍的CAI具有预后作用(HR 1.19,95%CI 1.03-1.38;p=0.018)。

整体研究工作流程图

综上所述,自动图像分析和机器学习可以提供一种客观、定量、可重复和高通量的方法来量化ICC面积。CAI对2级组癌症患者预后的表现表明了对于几乎没有格林森4模式的患者,ICC分数的预后作用较强

原始出处:

Patrick Leo, Sacheth Chandramouli, Xavier Farré et al. Computationally Derived Cribriform Area Index from Prostate Cancer Hematoxylin and Eosin Images Is Associated with Biochemical Recurrence Following Radical Prostatectomy and Is Most Prognostic in Gleason Grade Group 2. Eur Urol Focus. 2021

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    2021-06-05 zt123

    学习了一下

    0

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    2021-06-01 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

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