Clinical use of a machine learning histopathological image signature in diagnosis and survival prediction of clear cell renal cell carcinoma

Abstract

Due to the complicated histopathological characteristics of renal neoplasms, traditional distinguishing of clear cell renal cell carcinoma (ccRCC) by naked eyes of experienced pathologist remains labor intensive and time consuming. Here, we extracted quantitative features of hematoxylin-eosin-stained images using CellProfiler and performed machine learning method to develop and verify a novel computational recognition of digital pathology for diagnosis and prognosis of ccRCC patients in the training, test and external validation cohort. The diagnostic model based on digital pathology could accurately distinguish ccRCC from normal renal tissues, with area under the curve (AUC) of 96.0%, 94.5% and 87.6% in the training, test and external validation cohorts, respectively. It could also accurately distinguish ccRCC from other pathological types of renal cancer, with AUC values of 97.0% and 81.4% in the Cancer Genome Atlas (TCGA) cohort and General cohort. We next developed and verified a computational recognition prognosis model with risk score. There was a significant difference in disease-free survival comparing patients with high vs low risk score in training cohort (hazard ratio = 2.72, P