Multistain deep learning for prediction of prognosis and therapy response in colorectal cancer.

Journal: Nature medicine
Published Date: Jan 9, 2023

Abstract

Although it has long been known that the immune cell composition has a strong prognostic and predictive value in colorectal cancer (CRC), scoring systems such as the immunoscore (IS) or quantification of intraepithelial lymphocytes are only slowly being adopted into clinical routine use and have their limitations. To address this we established and evaluated a multistain deep learning model (MSDLM) utilizing artificial intelligence (AI) to determine the AImmunoscore (AIS) in more than 1,000 patients with CRC. Our model had high prognostic capabilities and outperformed other clinical, molecular and immune cell-based parameters. It could also be used to predict the response to neoadjuvant therapy in patients with rectal cancer. Using an explainable AI approach, we confirmed that the MSDLM's decisions were based on established cellular patterns of anti-tumor immunity. Hence, the AIS could provide clinicians with a valuable decision-making tool based on the tumor immune microenvironment.

Authors

  • Sebastian Foersch
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany. Electronic address: sebastian.foersch@unimedizin-mainz.de.
  • Christina Glasner
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Ann-Christin Woerl
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany; Institute of Computer Science, Johannes Gutenberg University Mainz, Mainz, Germany.
  • Markus Eckstein
    Institute of Pathology, University Hospitals Erlangen, Erlangen, Germany.
  • Daniel-Christoph Wagner
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Stefan Schulz
    Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria.
  • Franziska Kellers
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Aurélie Fernandez
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Konstantina Tserea
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Michael Kloth
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Arndt Hartmann
    Institute of Pathology, University Hospital of Friedrich-Alexander-University Erlangen-Nürnberg, Germany.
  • Achim Heintz
    Department of General Visceral and Vascular Surgery, Marien Hospital Mainz, Mainz, Germany.
  • Wilko Weichert
    Department of Pathology, School of Medicine, Technical University of Munich, Munich, Germany.
  • Wilfried Roth
    Institute of Pathology, University Medical Center Mainz, Mainz, Germany.
  • Carol Geppert
    Institute of Pathology and Comprehensive Cancer Center EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
  • Jakob Nikolas Kather
    Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
  • Moritz Jesinghaus
    Institute of Pathology, Technical University Munich, Munich, Germany.

Keywords

External Resources

Popular Topics
Recent Journals