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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.
Assuntos
Humanos , Linfócitos do Interstício Tumoral , Neoplasias Colorretais , Inteligência Artificial , Reprodutibilidade dos Testes , Prognóstico , Linfócitos T CD8-Positivos , Microambiente TumoralRESUMO
[Objective] To explore the clinical pathological characteristics and treatment of pancreatic careinoid. [Methods] Eight patients with pancreatic careinoid were recruited between January in 1997 and December in 2007 for retrospective analysis which involved tumor markers, inanunohistostaining, accompanied with other tumors, misdiagnosis, metastasis, in-hospital mortality rate, and so on. The relevant literatures were simultaneously reviewed to comprehend the clinical pathological characteristics of pancreatic carcinoid. [Results] Tumor markers CEA, CA199, CA125, and CA72-4 in pancreatic carcinoid were 0%, 25%, 12.5%, and 0%, respectively. Specimen immanohistostaining Syn, CgA, NSE, and CK in pancreatic carcinoid were 25%, 62.5%, 75%, and 75%, respectively. Two pancreatic carcinoids were accompanied by other tumors in 8 cases. The misdiagnosis rate of pancreatic carcinoid (7/8) was markedly high. Pancreatic carcinoid possessed high metastasis (50%), high in-hospital mortality rate (37.5%) and low radical operation undergone (62.5%). [Conclusions] Pancrcatic carcinoid was accompanied with high misdiagnosis rate and poor prognosis. Routine sero-markers did not help discover pancreatic carcinoid early. The final diagnosis depended on specimen immunohistostaining with Syn, CgA, NSE, and CK.
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@#Objective To explore the effects of ecoimmunonutrition support on the intestinal barrier function and pancreas in rats with severe acute pancreatitis (SAP). Methods Totally 64 SPF rats were randomly divided into sham operation group (control group) , SAP without enteral nutrition support group (SAP group), SAP with early enteral nutrition support group (EEN group), and SAP with early ecoimmunonutrition support group (EIN group). Bacteria translocation (BT), plasma endotoxin (ET) , gut permeability, pancreas pathology score,and distant ileum pathology were determined on the 4th and 7th post-modeling day. Results The BT rate was significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜ 0.05), was significantly lower in EEN group and EIN group than in SAP group (P ＜ 0.05), and was significantly lower in EIN group than in EEN group (P ＜ 0.05). ET and FD-40 levels in blood were both significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜0.01)and were significantly lower in EIN group and EEN group than in SAP group (P ＜0.01); ET was significantly lower in EIN group than in control group (P ＜0.05). Pathological scores were significantly higher in SAP group, EEN group, and EIN group than in control group (P ＜0.01)and were significantly lower in EEN group and EIN group than in SAP group (P ＜ 0.01). The individual pathological scores of EIN group were not significantly different from EEN group (P ＞ 0.05), while the total score was significantly lower in EIN group than in EEN group (P ＞ 0.05). Distant iliac mucosa was significantly thicker in EIN group than in other groups. Conclusions Early enteral nutrition support protects the intestinal barrier and pancreas in rats with SAP. Ecoimmunonutrition has better nutritional effectiveness than the normal enteral nutrition.