自动化多区域免疫组化评分提高结直肠癌的预后。

IF 3.7 2区 医学 Q1 PATHOLOGY
Jun Cheng, Yulong Han, Ye Yuan, Shuxiang Huang, Bin Xiao, Yuanyuan Kong, Wufeng Xue, Ruixue Yuan, Hailing Liu, Ping Lan, Xiaojian Wu, Youhui Qian, Dong Ni, Yufeng Chen
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引用次数: 0

摘要

肿瘤免疫微环境在结直肠癌(CRC)预后中起着至关重要的作用。然而,大多数研究在肿瘤区域手工评估一组有限的免疫标记物,而没有考虑多个组织区域的免疫异质性。本研究旨在通过开发一种自动化的多区域免疫组织化学(IHC)评分系统来提高CRC的预后评估。从CRC手术标本(n = 154)中提取了四个区域的两个代表性组织核心:肿瘤中心、浸润边缘、癌旁组织和正常组织。对15种免疫标记物进行免疫组化染色,并使用计算算法对数字化切片进行分析,以分类组织类型(如腺体、肿瘤和间质)并识别染色像素。在不同区域的不同组织类型中量化免疫浸润,并引入肿瘤与健康免疫比(THIR)评分来比较肿瘤与健康间质中免疫标志物的表达。评估IHC评分与总生存期(OS)和无复发生存期(RFS)之间的关系。计算模型的组织分类准确率为95.19%,染色鉴定准确率为97.90%。对120个IHC评分(15个标记物× 8种组织类型)的分析显示,免疫异质性显著,其中56个评分与OS相关,54个与RFS相关。值得注意的是,颗粒酶B和CD4等标志物在浸润边缘的预后相关性高于肿瘤中心,而S100和CD20等标志物在各区域的预后作用相反。综合多种标志物可显著提高预后准确性,在正常基质中联合标志物评分可提供最显著的风险分层(log-rank检验,p = 1.56e-7, OS)。THIR评分也与患者预后密切相关。这项研究通过自动化多区域免疫组化评分推进了结直肠癌的预后,强调了跨组织区域免疫异质性的重要性。这些发现支持将区域特异性免疫分析整合到临床工作流程中,以实现更加个性化和精确的患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Automated multi-regional IHC scoring enhances prognostication in colorectal cancer

Automated multi-regional IHC scoring enhances prognostication in colorectal cancer

Automated multi-regional IHC scoring enhances prognostication in colorectal cancer

Automated multi-regional IHC scoring enhances prognostication in colorectal cancer

The tumor immune microenvironment plays a critical role in colorectal cancer (CRC) prognosis. However, most studies assess a limited set of immune markers manually in the tumor region, without considering immune heterogeneity across multiple tissue regions. This study aims to enhance CRC prognostic assessment by developing an automated multi-regional immunohistochemistry (IHC) scoring system for 15 immune markers. Two representative tissue cores were extracted from CRC surgical specimens (n = 154) across four regions: tumor center, invasive margin, paracancerous tissues, and normal tissues. IHC staining was performed for 15 immune markers, and digitized slides were analyzed using computational algorithms to classify tissue types (e.g., glands, tumor, and stroma) and identify stained pixels. Immune infiltration was quantified in different tissue types across regions, and a tumor-to-healthy immune ratio (THIR) score was introduced to compare immune marker expression in tumor versus healthy stroma. Associations between IHC scores and overall survival (OS) and relapse-free survival (RFS) were evaluated. Computational models achieved 95.19% accuracy in tissue classification and 97.90% in staining identification. Analysis of 120 IHC scores (15 markers × 8 tissue types) revealed significant immune heterogeneity, with 56 scores correlating with OS and 54 with RFS. Notably, markers such as Granzyme B and CD4 had higher prognostic relevance at the invasive margin than the tumor center, while markers like S100 and CD20 exhibited opposing prognostic effects across regions. Integrating multiple markers significantly improved prognostic accuracy, with the combined marker score in normal stroma providing the most significant risk stratification (log-rank test, p = 1.56e-7, OS). The THIR score also strongly correlated with patient outcomes. This study advances CRC prognostication through automated multi-regional IHC scoring, highlighting the importance of immune heterogeneity across tissue regions. These findings support integrating region-specific immune profiling into clinical workflows for more personalized and precise patient care.

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来源期刊
Journal of Pathology Clinical Research
Journal of Pathology Clinical Research Medicine-Pathology and Forensic Medicine
CiteScore
7.40
自引率
2.40%
发文量
47
审稿时长
20 weeks
期刊介绍: The Journal of Pathology: Clinical Research and The Journal of Pathology serve as translational bridges between basic biomedical science and clinical medicine with particular emphasis on, but not restricted to, tissue based studies. The focus of The Journal of Pathology: Clinical Research is the publication of studies that illuminate the clinical relevance of research in the broad area of the study of disease. Appropriately powered and validated studies with novel diagnostic, prognostic and predictive significance, and biomarker discover and validation, will be welcomed. Studies with a predominantly mechanistic basis will be more appropriate for the companion Journal of Pathology.
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