中文摘要
TIL(肿瘤浸润淋巴细胞)(TILs)与上皮性卵巢癌患者生存改善相关。然而,由于可重复性问题,TIL评估尚未用于常规临床实践。
本研究开发了两个卷积神经网络模型,用于检测TILs并确定其在全切片图像中的空间位置,并建立了一个空间评估流程,以客观量化高级别浆液性卵巢癌患者的上皮内和间质TILs。所建立模型的预测与CD8+ T细胞数量和免疫基因表达呈显著正相关。在多个队列中,上皮内TILs密度较高的患者总生存期和无进展生存期显著延长。根据上皮内和间质TILs密度,患者被分为三种免疫表型:免疫炎症型、免疫排斥型和免疫荒漠型。免疫荒漠型亚组预后最差。基因表达分析显示,免疫荒漠型亚组的免疫细胞溶解活性和T细胞炎症基因表达谱评分较低,而免疫排斥型亚组的干扰素和程序性死亡受体1信号通路表达较高。所建立的评估方法对苏木精和伊红染色切片中的上皮内和间质TILs提供了详细且全面的量化。它具有用于卵巢癌患者个性化治疗的临床应用潜力。
展开英文摘要原文
Tumor-infiltrating lymphocytes (TILs) are associated with improved survival in patients with epithelial ovarian cancer.
However, TIL evaluation has not been used in routine clinical practice because of reproducibility issues. The current study developed two convolutional neural network models to detect TILs and to determine their spatial location in whole slide images, and established a spatial assessment pipeline to objectively quantify intraepithelial and stromal TILs in patients with high-grade serous ovarian carcinoma. The predictions of the established models showed a significant positive correlation with the number of CD8 + T cells and immune gene expressions. Patients with a higher density of intraepithelial TILs had a significantly prolonged overall survival and progression-free survival in multiple cohorts.
On the basis of the density of intraepithelial and stromal TILs, patients were classified into three immunophenotypes: immune inflamed, excluded, and desert. The immune-desert subgroup showed the worst prognosis. Gene expression analysis showed that the immune-desert subgroup had lower immune cytolytic activity and T-cell-inflamed gene-expression profile scores, whereas the immune-excluded subgroup had higher expression of interferon- and programmed death 1 receptor signaling pathway.
The established evaluation method provided detailed and comprehensive quantification of intraepithelial and stromal TILs throughout hematoxylin and eosin-stained slides. It has potential for clinical application for personalized treatment of patients with ovarian cancer.
论文信息
- 作者
- Hamada K、Murakami R、Ueda A、Kashima Y、Miyagawa C、Taki M、Yamanoi K、Yamaguchi K
- 第一作者单位
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.Japan
- 通讯作者单位
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: ryusukem@kuhp.kyoto-u.ac.jp.Japan
- 文献类型
- 非美国政府资助研究
- 期刊
- The American journal of pathology2024 Jul