Abstract
.Prostate cancer is the most common nonskin-related cancer, affecting one in seven men in the United States. Gleason score, a sum of the primary and secondary Gleason patterns, is one of the best predictors of prostate cancer outcomes. Recently, significant progress has been made in molecular subtyping prostate cancer through the use of genomic sequencing. It has been established that prostate cancer patients presented with a Gleason score 7 show heterogeneity in both disease recurrence and survival. We built a unified system using publicly available whole-slide images and genomic data of histopathology specimens through deep neural networks to identify a set of computational biomarkers. Using a survival model, the experimental results on the public prostate dataset showed that the computational biomarkers extracted by our approach had hazard ratio as 5.73 and -index as 0.74, which were higher than standard clinical prognostic factors and other engineered image texture features. Collectively, the results of this study highlight the important role of neural network analysis of prostate cancer and the potential of such approaches in other precision medicine applications.
Highlights
Prostate cancer remains the most common noncutaneous malignant tumor in the Western world accounting for approximately one in five of newly diagnosed tumors in men and resulting in an estimated 29,430 deaths in 2018.1 In the United States, approximately one in seven men will be diagnosed with this disease.[1]
We developed a computational biomarker quantification system by integrating histopathology whole-slide image (WSI) and genomic data into one deep neural network
We introduced our approach on building a unified system using WSI and genomic data through deep neural networks to quantify computational biomarkers, which were fed into a survival model for patients’ recurrence analysis
Summary
Prostate cancer remains the most common noncutaneous malignant tumor in the Western world accounting for approximately one in five of newly diagnosed tumors in men and resulting in an estimated 29,430 deaths in 2018.1 In the United States, approximately one in seven men will be diagnosed with this disease.[1]. Patients with Gleason score 6 or lower often undergo active surveillance as there is reduced risk of tumor progression for those patients compared to patients with score 7 or higher.[5,6] Tumors that are assigned Gleason score 7 can be delineated into a primary region exhibiting a histopathology pattern graded as 4 and a secondary region exhibiting a histopathology pattern graded as 3. Such samples are referred to as Gleason 4 þ 3 tumors, whereas the inverse pattern exhibiting a primary pattern of 3 and a secondary pattern of 4 would constitute a Gleason 3 þ 4 tumors. Patients with Gleason 4 þ 3 tumors have an increased risk of recurrence and progression leading to an increased risk of prostate cancer-specific mortality when compared to those afflicted with Gleason 3 þ 4 tumors.[7,8,9] The literature clearly shows that predicting disease recurrence in a man with Gleason score 7 prostate cancer can have a significant impact on his disease management and survival.[8,9,10]
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