Stroma and lymphocytes identified by deep learning are independent predictors for survival in pancreatic cancer.

Journal: Scientific reports
PMID: 40108402

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers known to humans. However, not all patients fare equally poor survival, and a minority of patients even survives advanced disease for months or years. Thus, there is a clinical need to search corresponding prognostic biomarkers which forecast survival on an individual basis. To dig more information and identify potential biomarkers from PDAC pathological slides, we trained a deep learning (DL) model based U-net-shaped backbone. This DL model can automatically detect tumor, stroma and lymphocytes on whole slide images (WSIs) of PDAC patients. We performed an analysis of 800 PDAC scans, categorizing stroma in percentage (SIP) and lymphocytes in percentage (LIP) into two and three categories, respectively. The presented model achieved remarkable accuracy results with a total accuracy of 94.72%, a mean intersection of union rate of 78.66%, and a mean dice coefficient of 87.74%. Survival analysis revealed that SIP-mediate and LIP-high groups correlated with enhanced median overall survival (OS) across all cohorts. These findings underscore the potential of SIP and LIP as prognostic biomarkers for PDAC and highlight the utility of DL as a tool for PDAC biomarkers detecting on WSIs.

Authors

  • Xiuxiang Tan
    Visceral and Transplant Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
  • Mika Rosin
    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
  • Simone Appinger
    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
  • Julia Campello Deierl
    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
  • Konrad Reichel
    Department of General, Visceral and Transplantation Surgery, Universitats Klinikum Essen, Essen, Germany.
  • Mariëlle Coolsen
    Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Liselot Valkenburg-van Iersel
    Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Judith de Vos-Geelen
    Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Evelien J M de Jong
    Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Jan Bednarsch
    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Bas Grootkoerkamp
    Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
  • Michail Doukas
    Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Casper van Eijck
    Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
  • Tom Luedde
    Division of Gastroenterology, Hepatology and Hepatobiliary Oncology, University Hospital RWTH Aachen, Aachen, Germany.
  • Edgar Dahl
    Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
  • Jakob Nikolas Kather
    Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
  • Shivan Sivakumar
    Department of Immunology and Immunotherapy, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
  • Wolfram Trudo Knoefel
    Department of General, Visceral and Pediatric Surgery, Heinrich Heine University, Düsseldorf, Germany.
  • Georg Wiltberger
    Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
  • Ulf Peter Neumann
    Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany.
  • Lara R Heij
    Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.

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