机构:[1]Sichuan Univ, West China Hosp, Dept Pathol, Chengdu, Peoples R China四川大学华西医院[2]Sichuan Univ, West China Hosp, Inst Clin Pathol, Chengdu, Peoples R China四川大学华西医院[3]Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pathol, Guangzhou, Peoples R China中山大学附属第一医院[4]Shanxi Med Univ, Chinese Acad Med Sci, Shanxi Prov Canc Hosp, Shanxi Hosp,Canc Hosp,Dept Pathol, Taiyuan, Peoples R China[5]Sichuan Prov Peoples Hosp, Dept Pathol, Chengdu, Peoples R China四川省人民医院[6]Southwest Med Univ, Affiliated Hosp, Dept Pathol, Luzhou, Peoples R China
Breast cancer patients exhibit variable responses to neoadjuvant therapy (NAT), necessitating robust predictive biomarkers. We developed an artificial intelligence (AI)-driven integrated predictive model (IPM) combining histopathological, clinical, and immune features to address this challenge. Using whole-slide images from 1035 patients across four centers, we compared tumor epithelium (TE-score), stroma (TS-score), and whole-tumor (TR-score) deep learning biomarkers, identifying TR-score as optimal (AUC = 0.729 vs. 0.686/0.719 for TE/TS-scores). The IPM, incorporating TR-score and clinical variables, demonstrated superior NAT response prediction versus clinicopathological models (validation AUC = 0.780 vs. 0.706, p < 0.001), with 10% higher accuracy. Immune profiling further enhanced performance (AUC = 0.831 vs. 0.822, p = 0.183). These results establish the biological and clinical validity of TR-score for characterizing tumor-stroma interactions, with IPM providing a generalizable framework for precision oncology. The model's stability across multicenter cohorts (AUCs 0.781-0.816) and incremental value of immune data suggest its utility in guiding NAT decision-making and trial stratification.
基金:
the National Natural Science Foundation of China [82404081]; National Natural Science Foundation of China [2024YFFK0339]; Sichuan Science and Technology Program [24NSFSC7843]; Natural Science Foundation Project of Science & Technology Department of Sichuan Province
第一作者机构:[1]Sichuan Univ, West China Hosp, Dept Pathol, Chengdu, Peoples R China[2]Sichuan Univ, West China Hosp, Inst Clin Pathol, Chengdu, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Li Fengling,Wei Yani,Zhang Wenchuan,et al.AI-powered prediction model for neoadjuvant chemotherapy efficacy: comprehensive analysis of breast cancer histological images[J].NPJ PRECISION ONCOLOGY.2025,9(1):doi:10.1038/s41698-025-01033-1.
APA:
Li, Fengling,Wei, Yani,Zhang, Wenchuan,Zhao, Yuanyuan,Fu, Jing...&Bu, Hong.(2025).AI-powered prediction model for neoadjuvant chemotherapy efficacy: comprehensive analysis of breast cancer histological images.NPJ PRECISION ONCOLOGY,9,(1)
MLA:
Li, Fengling,et al."AI-powered prediction model for neoadjuvant chemotherapy efficacy: comprehensive analysis of breast cancer histological images".NPJ PRECISION ONCOLOGY 9..1(2025)