Xinxing Li

Ling Zhang, Boxiang Yun, Ting Jin et al.

Prediction of genetic biomarkers, e.g., microsatellite instability in colorectal cancer is crucial for clinical decision making. But, two primary challenges hamper accurate prediction: (1) It is difficult to construct a pathology-aware representation involving the complex interconnections among pathological components. (2) WSIs contain a large proportion of areas unrelated to genetic biomarkers, which make the model easily overfit simple but irrelative instances. We hereby propose a Dictionary-based hierarchical pathology mining with hard-instance-assisted classifier Debiasing framework to address these challenges, dubbed as D2Bio. Our first module, dictionary-based hierarchical pathology mining, is able to mine diverse and very fine-grained pathological contextual interaction without the limit to the distances between patches. The second module, hard-instance-assisted classfier debiasing, learns a debiased classifier via focusing on hard but task-related features, without any additional annotations. Experimental results on five cohorts show the superiority of our method, with over 4% improvement in AUROC compared with the second best on the TCGA-CRC-MSI cohort. Our analysis further shows the clinical interpretability of D2Bio in genetic biomarker diagnosis and potential clinical utility in survival analysis. Code will be available at https://github.com/DeepMed-Lab-ECNU/D2Bio.

Ling Zhang, Boxiang Yun, Xingran Xie et al.

Prediction of genetic biomarkers, e.g., microsatellite instability and BRAF in colorectal cancer is crucial for clinical decision making. In this paper, we propose a whole slide image (WSI) based genetic biomarker prediction method via prompting techniques. Our work aims at addressing the following challenges: (1) extracting foreground instances related to genetic biomarkers from gigapixel WSIs, and (2) the interaction among the fine-grained pathological components in WSIs.Specifically, we leverage large language models to generate medical prompts that serve as prior knowledge in extracting instances associated with genetic biomarkers. We adopt a coarse-to-fine approach to mine biomarker information within the tumor microenvironment. This involves extracting instances related to genetic biomarkers using coarse medical prior knowledge, grouping pathology instances into fine-grained pathological components and mining their interactions. Experimental results on two colorectal cancer datasets show the superiority of our method, achieving 91.49% in AUC for MSI classification. The analysis further shows the clinical interpretability of our method. Code is publicly available at https://github.com/DeepMed-Lab-ECNU/PromptBio.