Automated digital TIL analysis (ADTA) adds prognostic value to standard assessment of depth and ulceration in primary melanoma

Sci Rep. 2021 Feb 2;11(1):2809. doi: 10.1038/s41598-021-82305-1.

Abstract

Accurate prognostic biomarkers in early-stage melanoma are urgently needed to stratify patients for clinical trials of adjuvant therapy. We applied a previously developed open source deep learning algorithm to detect tumor-infiltrating lymphocytes (TILs) in hematoxylin and eosin (H&E) images of early-stage melanomas. We tested whether automated digital (TIL) analysis (ADTA) improved accuracy of prediction of disease specific survival (DSS) based on current pathology standards. ADTA was applied to a training cohort (n = 80) and a cutoff value was defined based on a Receiver Operating Curve. ADTA was then applied to a validation cohort (n = 145) and the previously determined cutoff value was used to stratify high and low risk patients, as demonstrated by Kaplan-Meier analysis (p ≤ 0.001). Multivariable Cox proportional hazards analysis was performed using ADTA, depth, and ulceration as co-variables and showed that ADTA contributed to DSS prediction (HR: 4.18, CI 1.51-11.58, p = 0.006). ADTA provides an effective and attainable assessment of TILs and should be further evaluated in larger studies for inclusion in staging algorithms.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Chemotherapy, Adjuvant
  • Clinical Decision-Making / methods
  • Deep Learning
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted*
  • Kaplan-Meier Estimate
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Male
  • Melanoma / diagnosis
  • Melanoma / mortality*
  • Melanoma / pathology
  • Melanoma / therapy
  • Middle Aged
  • Neoplasm Staging
  • Patient Selection
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment / methods
  • Skin / cytology
  • Skin / pathology*
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy
  • Young Adult