Abstract P5-02-13: A novel detection technique for collagen (and other macromolecules) on H&E slides without special stains for improved cancer prognostics

Abstract

Abstract Background: Stromal density including the characterization of the type, abundance and alignment of collagen and other extracellular matrix (ECM) protein fibers in proximity to breast precancers and cancers has emerged as an important and evolving tool for understanding tumor progression and stratifying/classifying mortality risk. Standard methods for this evaluation including second harmonic generation (SHG) microscopy requires access to fresh or FFPE tissue samples of limited availability. In contrast, standard diagnostic H&E slides are more readily available for large retrospective and prospective studies. Methods: We developed a method for dual emission and transmission (DUET) microscopy that employs combined brightfield and fluorescence modalities, plus quantitative image analysis. The prototype instrument has whole-slide scanning capabilities for collagen detection and pixel-accurate alignment with conventional H&E-stained images. We have analyzed a retrospective cohort of 700 breast cancers with available outcome follow-up of greater than 5 years using this DUET method Results: DUET microscopy provides clear discrimination of collagen and ECM directly from standard H&E specimens, requiring only a few minutes to scan whole slides. Using the method, contrast enhancement similar to special staining techniques (e.g. trichrome, periodic acid Schiff’s, and picrosirius red stains). Image analysis from DUET directly corresponds to SHG data. DUET imaging discriminates between stroma surrounding invasive cancer and benign epithelium. DUET imaging of 700 breast cancers shows outcome correlation. Ongoing multivariate analysis comparing standard measures (grade, tumor infiltrating lymphocytes, tumor phenotype, etc.) to the DUET stromal score will be reported. Conclusions: DUET provides a straightforward, rapid and inexpensive approach for highlighting collagen distribution patterns on existing histology slides. This method should enable current research using improved quantitative tools, including AI-based, for correlation with patient outcomes, by enabling the use of standard and available H&E slides. Citation Format: Farzad Fereidouni, Alexander D. Borowsky, Richard M. Levenson. A novel detection technique for collagen (and other macromolecules) on H&E slides without special stains for improved cancer prognostics [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-02-13.