ABSTRACT
BACKGROUND@#Artificial intelligence (AI) technology represented by deep learning has made remarkable achievements in digital pathology, enhancing the accuracy and reliability of diagnosis and prognosis evaluation. The spatial distribution of CD3 + and CD8 + T cells within the tumor microenvironment has been demonstrated to have a significant impact on the prognosis of colorectal cancer (CRC). This study aimed to investigate CD3 CT (CD3 + T cells density in the core of the tumor [CT]) prognostic ability in patients with CRC by using AI technology.@*METHODS@#The study involved the enrollment of 492 patients from two distinct medical centers, with 358 patients assigned to the training cohort and an additional 134 patients allocated to the validation cohort. To facilitate tissue segmentation and T-cells quantification in whole-slide images (WSIs), a fully automated workflow based on deep learning was devised. Upon the completion of tissue segmentation and subsequent cell segmentation, a comprehensive analysis was conducted.@*RESULTS@#The evaluation of various positive T cell densities revealed comparable discriminatory ability between CD3 CT and CD3-CD8 (the combination of CD3 + and CD8 + T cells density within the CT and invasive margin) in predicting mortality (C-index in training cohort: 0.65 vs. 0.64; validation cohort: 0.69 vs. 0.69). The CD3 CT was confirmed as an independent prognostic factor, with high CD3 CT density associated with increased overall survival (OS) in the training cohort (hazard ratio [HR] = 0.22, 95% confidence interval [CI]: 0.12-0.38, P <0.001) and validation cohort (HR = 0.21, 95% CI: 0.05-0.92, P = 0.037).@*CONCLUSIONS@#We quantify the spatial distribution of CD3 + and CD8 + T cells within tissue regions in WSIs using AI technology. The CD3 CT confirmed as a stage-independent predictor for OS in CRC patients. Moreover, CD3 CT shows promise in simplifying the CD3-CD8 system and facilitating its practical application in clinical settings.
Subject(s)
Humans , Lymphocytes, Tumor-Infiltrating , Colorectal Neoplasms , Artificial Intelligence , Reproducibility of Results , Prognosis , CD8-Positive T-Lymphocytes , Tumor MicroenvironmentABSTRACT
Objective To investigate the protective effect of breviscapine on ischemia-reperfusion renal injury, which provides scientific theoretical basis for clinical prevention and treatment of renal ischemia-reperfusion injury. Method 36 SPF male healthy SD rats were randomly divided into 3 groups, 12 rats in each group. Group A was ischemia-reperfusion group, group B was erigeron breviscapus injection preconditioning group, and group C was sham operation group. Rats in group A and C were injected with normal saline, while rats in group B were given 12 ml/kg erigeron breviscapus injection by intraperitoneal injection., After 14 days, renal function, renal antioxidant indexes, renal cell apoptosis indexes and expression of Bcl-2, Bax in renal tissue of three groups were compared. Results The indexes of renal function showed that blood urea nitrogen (BUN) and Serum creatinine (SCr) in group B were significantly lower than group A (P<0.05), but significantly higher than group C (P<0.05). Renal antioxidant indexes showed that superoxide dismutase (SOD) and malondialdehyde (MDA) in group B were significantly higher than group A (P<0.05), but significantly lower than group C(P<0.05). The index of renal cell apoptosis showed that the apoptosis index AI in group B was significantly lower than group A (P<0.01), but significantly higher than group C (P<0.01). The results of immunohistochemical staining showed that the expression of Bcl-2 in group B were significantly higher than that of group A and group C (P<0.05), and the expression of Bax in group B was significantly lower than that in group A (P<0.05) while significantly higher than group C (P<0.01). The ratio of Bcl-2/Bax in group B was significantly higher than group A and group C (P<0.05). Conclusion Erigeron Breviscapus Injection may have a protective role on renal ischemia reperfusion injury though antioxidant and anti-apoptosis.