Evidence map›Paper›PMID 37777578›Full record

ArticleBritish journal of cancer2023

Evaluation of tumour infiltrating lymphocytes in luminal breast cancer using artificial intelligence.

Shorouk Makhlouf, Noorul Wahab, Michael Toss, Asmaa Ibrahim, Ayat G Lashen, Nehal M Atallah, Suzan Ghannam, Mostafa Jahanifar, Wenqi Lu, Simon Graham and 8 more

Abstract read
In one paragraph

Article in British journal of cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Shorouk Makhlouf *Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-3889-9659
Noorul Wahab *Tissue Image Analytics Centre, University of Warwick, Coventry, UK.
Michael TossAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-9077-3984
Asmaa IbrahimAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
Ayat G LashenAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-9494-7382
Nehal M AtallahAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-6845-5608
Suzan GhannamAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
Mostafa JahanifarTissue Image Analytics Centre, University of Warwick, Coventry, UK.
Wenqi LuTissue Image Analytics Centre, University of Warwick, Coventry, UK.
Simon GrahamTissue Image Analytics Centre, University of Warwick, Coventry, UK.
Nigel P MonganBiodiscovery Institute, School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK.
Mohsin BilalTissue Image Analytics Centre, University of Warwick, Coventry, UK.
Abhir BhaleraoTissue Image Analytics Centre, University of Warwick, Coventry, UK.
David SneadUniversity Hospital Coventry and Warwickshire, Coventry, UK.
Fayyaz MinhasTissue Image Analytics Centre, University of Warwick, Coventry, UK.
Shan E Ahmed RazaTissue Image Analytics Centre, University of Warwick, Coventry, UK.ORCID 0000-0002-1097-1738
Nasir RajpootTissue Image Analytics Centre, University of Warwick, Coventry, UK. n.m.rajpoot@warwick.ac.uk.
Emad RakhaAcademic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK. emad.rakha@nottingham.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTumour infiltrating lymphocytes (TILs) are a prognostic parameter in triple-negative and human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). However, their role in luminal (oestrogen receptor positive and HER2 negative (ER + /HER2-)) BC remains unclear. In this study, we used artificial intelligence (AI) to assess the prognostic significance of TILs in a large well-characterised cohort of luminal BC.

methodsSupervised deep learning model analysis of Haematoxylin and Eosin (H&E)-stained whole slide images (WSI) was applied to a cohort of 2231 luminal early-stage BC patients with long-term follow-up. Stromal TILs (sTILs) and intratumoural TILs (tTILs) were quantified and their spatial distribution within tumour tissue, as well as the proportion of stroma involved by sTILs were assessed. The association of TILs with clinicopathological parameters and patient outcome was determined.

resultsA strong positive linear correlation was observed between sTILs and tTILs. High sTILs and tTILs counts, as well as their proximity to stromal and tumour cells (co-occurrence) were associated with poor clinical outcomes and unfavourable clinicopathological parameters including high tumour grade, lymph node metastasis, large tumour size, and young age. AI-based assessment of the proportion of stroma composed of sTILs (as assessed visually in routine practice) was not predictive of patient outcome. tTILs was an independent predictor of worse patient outcome in multivariate Cox Regression analysis.

conclusionAI-based detection of TILs counts, and their spatial distribution provides prognostic value in luminal early-stage BC patients. The utilisation of AI algorithms could provide a comprehensive assessment of TILs as a morphological variable in WSIs beyond eyeballing assessment.

Indexed as

Breast NeoplasmsTriple Negative Breast NeoplasmsArtificial IntelligenceBiomarkers, TumorFemaleHumansLymphocytes, Tumor-InfiltratingPrognosisBiomarkers, Tumor

Identifiers

PMID37777578
PMCPMC10667537

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.