You have accessJournal of UrologyKidney Cancer: Basic Research & Pathophysiology II (PD49)1 Sep 2021PD49-04 ACCURATE DIFFERENTIATION OF PATHOLOGICAL SUBTYPES OF RENAL TUMOUR BY APPLYING A MACHINE LEARNING MODEL TO EPIGENETIC MARKERS Sabrina Rossi, Izzy Newsham, Sara Pita, Gahee Park, Radolsaw Lach, Anne Babbage, Christopher Smith, Kevin Brennan, Hong Zheng, Tom Mitchell, Anne Warren, John Leppert, Olivier Gevaert, Grant Stewart, Charles Massie, and Shamith Samarajiwa Sabrina RossiSabrina Rossi More articles by this author , Izzy NewshamIzzy Newsham More articles by this author , Sara PitaSara Pita More articles by this author , Gahee ParkGahee Park More articles by this author , Radolsaw LachRadolsaw Lach More articles by this author , Anne BabbageAnne Babbage More articles by this author , Christopher SmithChristopher Smith More articles by this author , Kevin BrennanKevin Brennan More articles by this author , Hong ZhengHong Zheng More articles by this author , Tom MitchellTom Mitchell More articles by this author , Anne WarrenAnne Warren More articles by this author , John LeppertJohn Leppert More articles by this author , Olivier GevaertOlivier Gevaert More articles by this author , Grant StewartGrant Stewart More articles by this author , Charles MassieCharles Massie More articles by this author , and Shamith SamarajiwaShamith Samarajiwa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002071.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Small renal masses (SRM) represent a diagnostic challenge despite advances in imaging and renal biopsy. Approximately 20% of SRM removed at surgery are found to be benign post-operatively. DNA methylation is an early and stable event in tumorigenesis, which reveals cell ontology. We developed and validated a machine learning model, leveraging DNA methylation analysis in >1500 patient samples, to classify pathological subtypes of renal tumours and provide a platform to improve diagnosis. METHODS: Methylation was evaluated in gDNA from fresh frozen nephrectomy specimens, using the Illumina 450k microarray and EPIC Methyl Capture sequencing platforms. We combined our own dataset and TCGA data (N=approx 158000 markers). This dataset was divided into training and testing sets, using 4-fold cross validation, and used to train an XGBoost model to classify samples into one of five pathological subtypes. External validation was carried out on two independent publicly available datasets, from fresh frozen nephrectomy tissue (Brennan et al) and ex-vivo tissue biopsies (Chopra et al). RESULTS: The integrated training and testing set consisted of 1268 samples, including: 465 ccRCC, 303 pRCC, 101 chRCC, 73 oncocytomas and 329 adjacent normal kidney. The prediction accuracy in the testing set was 0.954; with high class-wise Area Under the Receiver Operating Characteristic Curves (ROC AUCs): 0.994 (ccRCC), 0.995 (pRCC), 0.982 (chRCC), 0.999 (oncocytoma), 1 (adjacent normal). The model was externally validated on 245 ex-vivo tissue biopsies from 100 renal tumours. The accuracy was 0.824 and average class-wise ROC AUCs were: 0.978 (ccRCC), 0.946 (pRCC), 0.994 (chRCC), 0.892 (oncocytoma), 0.969 (adjacent normal). Furthermore, an independent external validation was performed on 34 tissue samples, achieving average class-wise ROC AUCs: 1 (ccRCC), 0.904 (chRCC), 0.946 (oncocytoma), 0.976 (adjacent normal). In order to assess the impact of methylation heterogeneity on our classifier, the model was evaluated in 97 multi-region samples from 18 ccRCC patients. CONCLUSIONS: A machine learning model based on DNA methylation data can differentiate pathological subtypes of renal tumours with excellent accuracy, including external validation. The model may be applied to renal biopsy samples to improve the diagnostic pathway for renal tumours. This has the potential to reduce over-treatment by preventing unnecessary surgery, enhance patient QoL and minimize healthcare costs. Source of Funding: S.H. Rossi is funded by a Cancer Research UK Doctoral Research (PhD) fellowship © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e846-e846 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sabrina Rossi More articles by this author Izzy Newsham More articles by this author Sara Pita More articles by this author Gahee Park More articles by this author Radolsaw Lach More articles by this author Anne Babbage More articles by this author Christopher Smith More articles by this author Kevin Brennan More articles by this author Hong Zheng More articles by this author Tom Mitchell More articles by this author Anne Warren More articles by this author John Leppert More articles by this author Olivier Gevaert More articles by this author Grant Stewart More articles by this author Charles Massie More articles by this author Shamith Samarajiwa More articles by this author Expand All Advertisement Loading ...
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