Predicting gastric cancer outcome from resected lymph node histopathology images using deep learning

Nat Commun. 2021 Mar 12;12(1):1637. doi: 10.1038/s41467-021-21674-7.

Abstract

N-staging is a determining factor for prognostic assessment and decision-making for stage-based cancer therapeutic strategies. Visual inspection of whole-slides of intact lymph nodes is currently the main method used by pathologists to calculate the number of metastatic lymph nodes (MLNs). Moreover, even at the same N stage, the outcome of patients varies dramatically. Here, we propose a deep-learning framework for analyzing lymph node whole-slide images (WSIs) to identify lymph nodes and tumor regions, and then to uncover tumor-area-to-MLN-area ratio (T/MLN). After training, our model's tumor detection performance was comparable to that of experienced pathologists and achieved similar performance on two independent gastric cancer validation cohorts. Further, we demonstrate that T/MLN is an interpretable independent prognostic factor. These findings indicate that deep-learning models could assist not only pathologists in detecting lymph nodes with metastases but also oncologists in exploring new prognostic factors, especially those that are difficult to calculate manually.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Deep Learning*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Node Excision / methods*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology*
  • Survival Analysis

Associated data

  • figshare/10.6084/m9.figshare.13065986