Cited by 18AI in cancer detectionRadiomics and Machine Learning in Medical ImagingCancer Immunotherapy and Biomarkers

Deep learning analysis of histopathological images predicts immunotherapy prognosis and reveals tumour microenvironment features in non-small cell lung cancer

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Wang, Youyu, Ju, Xueming, Hua, Rong, Chen, Ji, Dai, Xiaoqin, Liu, Lunxu, Wang, Guifang, Bai, Yifeng +2 more·2024·British Journal of Cancer

Abstract

Background Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer mortality worldwide. Immune checkpoint inhibitors (ICIs) have emerged as a crucial treatment option for patients with advanced NSCLC. However, only a subset of patients experience clinical benefit from ICIs. Therefore, identifying biomarkers that can predict response to ICIs is imperative for optimising patient selection. Methods Hematoxylin and eosin (H&E) images of NSCLC patients were obtained from the local cohort (n = 106) and The Cancer Genome Atlas (TCGA) (n = 899). We developed an ICI-related pathological prognostic signature (ir-PPS) based on H&E stained histopathology images to predict prognosis in NSCLC patients treated with ICIs using deep learning. To accomplish this, we employed a modified ResNet model (ResNet18-PG), a widely-used deep learning architecture well-known for its effectiveness in handling complex image recognition tasks. Our modifications include a progressive growing strategy to improve the stability of model training and the use of the AdamW optimiser, which enhances the optimisation process by adjusting the learning rate based on training dynamics. Results The deep learning model, ResNet18-PG, achieved an area under the receiver operating characteristic curve (AUC) of 0.918 and a recall of 0.995 on the local cohort. The ir-PPS effectively risk-stratified NSCLC patients. Patients in the low-risk group (n = 40) had significantly improved progression-free survival (PFS) after ICI treatment compared to those in the high-risk group (n = 66, log-rank P = 0.004, hazard ratio (HR) = 3.65, 95%CI: 1.75-7.60). The ir-PPS demonstrated good discriminatory power for predicting 6-month PFS (AUC = 0.750), 12-month PFS (AUC = 0.677), and 18-month PFS (AUC = 0.662). The low-risk group exhibited increased expression of immune checkpoint molecules, cytotoxicity-related genes, an elevated abundance of tumour-infiltrating lymphocytes, and enhanced activity in immune stimulatory pathways. Conclusions The ir-PPS signature derived from H&E images using deep learning could predict ICIs prognosis in NSCLC patients. The ir-PPS provides a novel imaging biomarker that may help select optimal candidates for ICIs therapy in NSCLC.

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  1. Luo X, Zang X, Yang L, Huang J, Liang F, Rodriguez-Canales J, et al. Compre- hensive computational pathological image analysis predicts lung cancer prog- nosis. J Thorac Oncol. 2017;12:501-9.

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Authors
Wang, Y., Ju, X., Hua, R., Chen, J., Dai, X., Liu, L., Wang, G., Bai, Y., Hu, H., & Li, X.
Affiliations
  • University of Electronic Science and Technology of China (CN)
  • Chengdu Seventh People's Hospital (CN)
  • Sichuan University (CN)
Corresponding author
  • Wang, Guifang
  • Bai, Yifeng
  • Hu, Honglin
  • Li, Xiaohua
Venue
British Journal of Cancer
Published
2024-10-25
Volume
131
Issue
11
Pages
1833-1845
ISSN
  • 0007-0920 (ISSN-L)
  • 1532-1827
OpenAlex
W4403768133
Cited by
18
References
64
Citations by year
2026: 11 · 2025: 7
FWCI
2.34
Type
journal article
Language
en
Open access
Locations
  • British Journal of Cancer (publishedVersion)
  • SSRN Electronic Journal (acceptedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
Funders
  • Department of Science and Technology of Sichuan Province
  • Sichuan Provincial Administration of Traditional Chinese Medicine (2023ZD021, 2021MS276)
  • Health Commission of Sichuan Province
  • Sichuan Province Science and Technology Support Program
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
Keywords
non-small cell lung cancer, immune checkpoint inhibitors, immunotherapy response prediction, tumor microenvironment, H&E histopathology, deep learning, tumor-infiltrating lymphocytes, immune checkpoint molecules, progression-free survival, biomarkers, risk stratification, TCGA
MeSH terms
Deep Learning, Immune Checkpoint Inhibitors, Aged, Carcinoma, Non-Small-Cell Lung, Female, Humans, Immunotherapy, Lung Neoplasms, Male, Middle Aged, Prognosis, Biomarkers, Tumor, Tumor Microenvironment

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