Pathomics Signature for Prognosis and Chemotherapy Benefits in Stage III Colon Cancer

Jiang, Wei3,4; Wang, Huaiming5,6; Dong, Xiaoyu3; Yu, Xian3,7,8,9; Zhao, Yandong10; Chen, Dexin3; Yan, Botao3; Cheng, Jiaxin3; Zhuo, Shuangmu4; Wang, Hui2,5,6; Yan, Jun1,3,11

2024-05-01

10.1001/jamasurg.2023.8015

JAMA SURGERY   影响因子和分区

2168-6254

2168-6262

Importance: The current TNM staging system may not provide adequate information for prognostic purposes and to assess the potential benefits of chemotherapy for patients with stage III colon cancer. Objective: To develop and validate a pathomics signature to estimate prognosis and benefit from chemotherapy using hematoxylin-eosin (H-E)-stained slides. Design, setting, and participants: This retrospective prognostic study used data from consecutive patients with histologically confirmed stage III colon cancer at 2 medical centers between January 2012 and December 2015. A total of 114 pathomics features were extracted from digital H-E-stained images from Nanfang Hospital of Southern Medical University, Guangzhou, China, and a pathomics signature was constructed using a least absolute shrinkage and selection operator Cox regression model in the training cohort. The associations of the pathomics signature with disease-free survival (DFS) and overall survival (OS) were evaluated. Patients at the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, formed the validation cohort. Data analysis was conducted from September 2022 to March 2023. Main outcomes and measures: The prognostic accuracy of the pathomics signature as well as its association with chemotherapy response were evaluated. Results: This study included 785 patients (mean [SD] age, 62.7 [11.1] years; 437 [55.7%] male). A pathomics signature was constructed based on 4 features. Multivariable analysis revealed that the pathomics signature was an independent factor associated with DFS (hazard ratio [HR], 2.46 [95% CI, 2.89-4.13]; P < .001) and OS (HR, 2.78 [95% CI, 2.34-3.31]; P < .001) in the training cohort. Incorporating the pathomics signature into pathomics nomograms resulted in better performance for the estimation of prognosis than the traditional model in a concordance index comparison in the training cohort (DFS: HR, 0.88 [95% CI, 0.86-0.89] vs HR, 0.73 [95% CI, 0.71-0.75]; P < .001; OS: HR, 0.85 [95% CI, 0.84-0.86] vs HR, 0.74 [95% CI, 0.72-0.76]; P < .001) and validation cohort (DFS: HR, 0.83 [95% CI, 0.82-0.85] vs HR, 0.70 [95% CI, 0.67-0.72]; P < .001; OS: HR, 0.80 [95% CI, 0.78-0.82] vs HR, 0.69 [0.67-0.72]; P < .001). Further analysis revealed that patients with a low pathomics signature were more likely to benefit from chemotherapy (eg, combined cohort: DFS: HR, 0.44 [95% CI, 0.28-0.69]; P = .001; OS: HR, 0.43 [95% CI, 0.29-0.64]; P < .001). Conclusions and relevance: These findings suggest that a pathomics signature could help identify patients most likely to benefit from chemotherapy in stage III colon cancer.

SCI

英语

通讯

National Natural Science Foundation of China["82273360","82103041","62375104"] ; Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Cancer[2020B121201004] ; Postdoctoral Fellowship Program of CPSF[GZC20231069] ; Guangdong Provincial Major Talents Project[2019JC05Y361] ; Science and Technology Planning Project of Guangzhou City[202206010085] ; Clinical Research Project of Nanfang Hospital["2020CR001","2020CR011"] ; President Foundation of Nanfang Hospital, Southern Medical University[2022B021] ; National Training Program for Undergraduate Innovation and Entrepreneurship["202212121011","S202212121104","S202212121092"]

Surgery

Surgery

WOS:001178810900002

AMER MEDICAL ASSOC

Web of Science

1.Southern Med Univ, Nanfang Hosp, Dept Gen Surg, 1838 Guangzhouda Rd, Guangzhou 510515, Guangdong, Peoples R China
2.Sun Yat Sen Univ, Affiliated Hosp 6, Dept Colorectal Surg, 26 Yuancun Erheng Rd, Guangzhou 510655, Guangdong, Peoples R China
3.Southern Med Univ, Sch Clin Med 1, Dept Gen Surg, Guangdong Prov Key Lab Precis Med Gastrointestinal, Guangzhou, Peoples R China
4.Jimei Univ, Sch Sci, Xiamen, Peoples R China
5.Sun Yat Sen Univ, Dept Colorectal Surg, Guangdong Prov Key Lab Colorectal & Pelv Floor Dis, Supported Natl Key Clin Discipline,Affiliated Hosp, Guangzhou, Peoples R China
6.Sun Yat Sen Univ, Affiliated Hosp 6, Guangdong Inst Gastroenterol, Supported Natl Key Clin Discipline, Guangzhou, Peoples R China
7.Chongqing Univ, Canc Hosp, Key Lab Biorheol Sci & Technol, Minist Educ, Chongqing, Peoples R China
8.Chongqing Canc Inst, Chongqing, Peoples R China
9.Chongqing Canc Hosp, Chongqing, Peoples R China
10.Sun Yat Sen Univ, Affiliated Hosp 6, Dept Pathol, Guangzhou, Peoples R China
11.Dept Gastrointestinal Surg Jinan Univ Shenzhen Peo, Southern Univ Sci & Technol, Affiliated Hosp 1, Dept Gastrointestinal Surg,Jinan Univ,Shenzhen Peo, Shenzhen, Peoples R China

Jiang, Wei,Wang, Huaiming,Dong, Xiaoyu,et al. Pathomics Signature for Prognosis and Chemotherapy Benefits in Stage III Colon Cancer[J]. JAMA SURGERY,2024.

Jiang, Wei.,Wang, Huaiming.,Dong, Xiaoyu.,Yu, Xian.,Zhao, Yandong.,...&Yan, Jun.(2024).Pathomics Signature for Prognosis and Chemotherapy Benefits in Stage III Colon Cancer.JAMA SURGERY.

Jiang, Wei,et al."Pathomics Signature for Prognosis and Chemotherapy Benefits in Stage III Colon Cancer".JAMA SURGERY (2024).