Journal
AMERICAN JOURNAL OF PATHOLOGY
Volume 192, Issue 6, Pages 904-916Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajpath.2022.03.006
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Funding
- Takeda Science Foundation
- Senri Life Science Foundation
- Kanae Foundation for the Promotion of Medical Science
- Japan Society for the Promotion of Science Grants-in-Aid for Early-Career Scientists [JP20K16192]
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This study successfully predicted postoperative recurrence of Crohn disease (CD) by computational analysis of histopathologic images and identified histologic characteristics associated with recurrence, including adipose cell morphology and subserosal mast cell infiltration.
Most patients with Crohn disease (CD), a chronic inflammatory gastrointestinal disease, experience recurrence despite treatment, including surgical resection. However, methods for predicting recurrence remain unclear. This study aimed to predict postoperative recurrence of CD by computational analysis of histopathologic images and to extract histologic characteristics associated with recurrence. A total of 68 patients who underwent surgical resection of the intestine were included in this study and were categorized into two groups according to the presence or absence of postoperative disease recurrence within 2 years after surgery. Recurrence was defined using the CD Activity Index and the Rutgeerts score. Whole-slide images of surgical specimens were analyzed using deep learning model EfficientNetb5, which achieved a highly accurate prediction of recurrence (area under the curve, 0.995). Moreover, subserosal tissue images with adipose cells enabled highly accurate prediction. Adipose cell morphology showed significant between-group differences in adipose cell size, cell-to-cell distance, and cell flattening values. These findings suggest that adipocyte shrinkage is an important histologic characteristic associated with recurrence. Moreover, there was a significant between-group difference in the degree of mast cell infiltration in the subserosa. These findings show the importance of mesenteric adipose tissue in patient prognosis and CD pathophysiology. These findings also suggest that deep learning-based artificial intelligence enables the extraction of meaningful histologic features. (Am J Pathol 2022, 192: 904-916; https://doi.org/10.1016/j.ajpath.2022.03.006)
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