Deep Learning Image Analysis Algorithms to Improve Oral Cancer Risk Assessment for Oral Potentially Malignant Disorders

摘要 口腔潜在恶性疾病(OPMD)是口腔中的一组黏膜疾病，具有 进展为口腔鳞状细胞癌。传统上，风险评估是通过以下组合来完成的 临床和组织学评价。白斑是OPMD的一种常见类型，根据组织学分级 被认为与其进展风险相关的分数。然而，有巨大的内部和内部 异型增生分级中的观察者异质性，导致风险评估和 治疗计划。这也阻碍了研究这些损伤的生物学的能力。我们建议使用完整的 常规苏木精伊红染色切片的玻片成像结合深度学习 方法建立统一的OPMD风险评分体系。我们的方法将识别细胞、细胞核和组织 与OPMD进展风险相关的架构特征。这些功能将进行大规模测试 回顾性病例对照研究，然后进行前瞻性验证。我们还将探索将它们与 基因组和免疫生物标记物，以提高预后能力和探索 OPMD的进展。我们希望这些努力将改善和规范OPMD的风险评估。 这可以通过实现风险分层和允许未来 临床试验将在更统一的患者队列中进行。同样，它可以提高我们对 OPMD的生物学和向癌症发展的过程。

Abstract Oral potentially malignant disorders (OPMD) are a group of mucosal diseases in the oral cavity with a risk of progressing to oral squamous cell carcinoma. Risk assessment is traditionally done through a combination of clinical and histologic evaluation. Leukoplakia is a common type of OPMD that is given a histologic grading score that is supposed to be related to its risk of progression. However, there is tremendous intra- and inter- observer heterogeneity in dysplasia grading, leading to variability and uncertainty in risk assessment and treatment planning. This also hinders the ability to study the biology of these lesions. We propose to use whole slide imaging on routine hematoxylin and eosin (H&E) stained sections in combination with deep learning methods to build a consistent risk scoring system for OPMD. Our methods will identify cell, nucleus, and tissue architectural features relevant to risk of progression in OPMD. These features will be tested in a large retrospective case-control study and then validated prospectively. We will also explore combining them with genomic and immune biomarkers in order to improve the prognostic power and explore the biolo gy of progression in OPMD. We hope that these efforts will improve and standardize risk assessment for OPMD. This could lead to improved treatment and prevention options by enabling risk stratification and allowing future clinical trials be conducted in a more uniform patient cohort. Similarly, it could improve our understanding for the biology of OPMD and the process of progression to cancer.