Ovarian cancer ranks among the deadliest gynecological malignancies, with high-grade serous adenocarcinoma (HGSA) constituting 75 % of ovarian cancer cases and accounting for 80 %–90 % of ovarian cancer-related fatalities. Accurate prognosis prediction for ovarian HGSA is of critical clinical significance. However, existing prognostic analysis methods exhibit suboptimal performance in identifying prognostically relevant pathological markers, making it challenging, even for experienced pathologists, to forecast the prognosis of ovarian HGSA patients accurately. Deep learning holds promise in enhancing prognostic prediction accuracy. However, a significant challenge in this field arises from the impracticality of directly inputting histopathology whole-slide images with millions to billions of pixels into existing deep learning networks for training and inference. To address this issue, we propose a prognostic analysis network for ovarian cancer based on hierarchical sampling and fine-grained recognition. This network comprises a two-stage hierarchical sampling sub-network, a fine-grained image recognition sub-network, and a prognostic analysis sub-network. We assess the system's performance using a pathological dataset of 450 cases of ovarian HGSA diagnosed and treated at the Pathology Department of the West China Second University Hospital of Sichuan University. Results indicate that: (1) The proposed prognostic analysis network based on two-stage hierarchical sampling sub-network can effectively analyze the histopathology whole-slide image; (2) the use of fine-grained image recognition and the introduction of clinical information can improve the performance of HGSA prognosis analysis method, with an improvement range of 4.77–10.66%; and (3) the proposed method can be used for the model analysis of pathological datasets of HGSA. Moreover, this method can be used to explore effective characteristics from the multi-modal dataset through automatic learning with prediction recall, accuracy, and precision rates of 80.0%, 81.1%, and 81.8%, respectively, underscoring its clinical potential. This study reveals the reliability and effectiveness of the proposed prognosis evaluation method of HGCA. Conclusions can help clinicians precisely evaluate the recurrence risk of patients, take the initiative to master the diagnosis and treatment, and increase the long-term survival rate of patients.
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