Computerized tumor multinucleation index (MuNI) is prognostic in p16+ oropharyngeal carcinoma.

BACKGROUNDPatients with p16+ oropharyngeal squamous cell carcinoma (OPSCC) are potentially cured with definitive treatment. However, there are currently no reliable biomarkers of treatment failure for p16+ OPSCC. Pathologist-based visual assessment of tumor cell multinucleation (MN) has been shown t...

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Published in:Journal of Clinical Investigation Vol. 131; no. 8; pp. 1 - 12
Main Authors: Koyuncu, Can F., Cheng Lu, Bera, Kaustav, Zelin Zhang, Jun Xu, Toro, Paula, Corredor, German, Chute, Deborah, Pingfu Fu, Thorstad, Wade L., Faraji, F., Bishop, Justin A., Mehrad, Mitra, Castro, Patricia D., Sikora, Andrew G., Thompson, Lester D. R., Chernock, R. D., Lang Kuhs, Krystle A., Jingqin Luo, Sandulache, Vlad
Format: pictorial research tables/charts Journal Article
Published: American Society for Clinical Investigation 4/15/2021
Online Access:View this record in EBSCOhost
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      dt: 4/15/2021
      vid: 131
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      pub: American Society for Clinical Investigation
      place: Ann Arbor, Michigan
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        atl: Computerized tumor multinucleation index (MuNI) is prognostic in p16+ oropharyngeal carcinoma.
      aug:
        au:
          Koyuncu, Can F.
          Cheng Lu
          Bera, Kaustav
          Zelin Zhang
          Jun Xu
          Toro, Paula
          Corredor, German
          Chute, Deborah
          Pingfu Fu
          Thorstad, Wade L.
          Faraji, F.
          Bishop, Justin A.
          Mehrad, Mitra
          Castro, Patricia D.
          Sikora, Andrew G.
          Thompson, Lester D. R.
          Chernock, R. D.
          Lang Kuhs, Krystle A.
          Jingqin Luo
          Sandulache, Vlad
        affil: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
      sug:
        subj:
          Proteins Metabolism
          Head and Neck Neoplasms Mortality
          Head and Neck Neoplasms Metabolism
          Image Processing, Computer Assisted
          Head and Neck Neoplasms Pathology
          Female
          Middle Age
          Survival
          Human
          Prognosis
          Male
          Aged
          Prospective Studies
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: BACKGROUNDPatients with p16+ oropharyngeal squamous cell carcinoma (OPSCC) are potentially cured with definitive treatment. However, there are currently no reliable biomarkers of treatment failure for p16+ OPSCC. Pathologist-based visual assessment of tumor cell multinucleation (MN) has been shown to be independently prognostic of disease-free survival (DFS) in p16+ OPSCC. However, its quantification is time intensive, subjective, and at risk of interobserver variability.METHODSWe present a deep-learning-based metric, the multinucleation index (MuNI), for prognostication in p16+ OPSCC. This approach quantifies tumor MN from digitally scanned H&E-stained slides. Representative H&E-stained whole-slide images from 1094 patients with previously untreated p16+ OPSCC were acquired from 6 institutions for optimization and validation of the MuNI.RESULTSThe MuNI was prognostic for DFS, overall survival (OS), or distant metastasis-free survival (DMFS) in p16+ OPSCC, with HRs of 1.78 (95% CI: 1.37-2.30), 1.94 (1.44-2.60), and 1.88 (1.43-2.47), respectively, independent of age, smoking status, treatment type, or tumor and lymph node (T/N) categories in multivariable analyses. The MuNI was also prognostic for DFS, OS, and DMFS in patients with stage I and stage III OPSCC, separately.CONCLUSIONMuNI holds promise as a low-cost, tissue-nondestructive, H&E stain-based digital biomarker test for counseling, treatment, and surveillance of patients with p16+ OPSCC. These data support further confirmation of the MuNI in prospective trials.FUNDINGNational Cancer Institute (NCI), NIH; National Institute for Biomedical Imaging and Bioengineering, NIH; National Center for Research Resources, NIH; VA Merit Review Award from the US Department of VA Biomedical Laboratory Research and Development Service; US Department of Defense (DOD) Breast Cancer Research Program Breakthrough Level 1 Award; DOD Prostate Cancer Idea Development Award; DOD Lung Cancer Investigator-Initiated Translational Research Award; DOD Peer-Reviewed Cancer Research Program; Ohio Third Frontier Technology Validation Fund; Wallace H. Coulter Foundation Program in the Department of Biomedical Engineering; Clinical and Translational Science Award (CTSA) program, Case Western Reserve University; NCI Cancer Center Support Grant, NIH; Career Development Award from the US Department of VA Clinical Sciences Research and Development Program; Dan L. Duncan Comprehensive Cancer Center Support Grant, NIH; and Computational Genomic Epidemiology of Cancer Program, Case Comprehensive Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, the US Department of VA, the DOD, or the US Government.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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