Artificial intelligence-based multi-modal multi-tasks analysis reveals tumor molecular heterogeneity, predicts preoperative lymph node metastasis and prognosis in papillary thyroid carcinoma: a retrospective study

作者：Yunfang Yu, Wenhao Ouyang, Yunxi Huang, Hong Huang, Zehua Wang, Xueyuan Jia, Zhenjun Huang, Ruichong Lin, Yue Zhu, Yisitandaer yalikun, Langping Tan, Xi Li, Fei Zhao, Zhange Chen, Wenting Li, Jianwei Liao, Herui Yao, Miaoyun Long · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000001875 · 被引用次数：37 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Ferroptosis and cancer prognosis、Single-cell and spatial transcriptomics

BACKGROUND: Papillary thyroid carcinoma (PTC) is the predominant form of thyroid cancer globally, especially when lymph node metastasis (LNM) occurs. Molecular heterogeneity, driven by genetic alterations and tumor microenvironment components, contributes to the complexity of PTC. Understanding these complexities is essential for precise risk stratification and therapeutic decisions. METHODS: This study involved a comprehensive analysis of 521 patients with PTC from our hospital and 499 patients from The Cancer Genome Atlas (TCGA). The real-world cohort 1 comprised 256 patients with stage I-III PTC. Tissues from 252 patients were analyzed by DNA-based next-generation sequencing, and tissues from four patients were analyzed by single-cell RNA sequencing (scRNA-seq). Additionally, 586 PTC pathological sections were collected from TCGA, and 275 PTC pathological sections were collected from the real-world cohort 2. A deep-learning multi-modal model was developed using matched histopathology images, genomic, transcriptomic, and immune cell data to predict LNM and disease-free survival (DFS). RESULTS: This study included a total of 1011 PTC patients, comprising 256 patients from cohort 1, 275 patients from cohort 2, and 499 patients from TCGA. In cohort 1, the authors categorized PTC into four molecular subtypes based on BRAF, RAS, RET, and other mutations. BRAF mutations were significantly associated with LNM and impacted DFS. ScRNA-seq identified distinct T-cell subtypes and redu...