Presentation Authors: Tyler Etheridge, Adam Schultz, Johnathon McCormick, Shivashankar Damodaran, Bing Yang*, Glenn O. Allen, Wei Huang, Madison, WI, Peter LaViolette, Milwaukee, WI, David Jarrard, Madison, WI
Introduction: A field of cancer susceptibility exists for many tumors, including prostate. Here we question whether digital imaging and computer-based analysis can distinguish differences in benign appearing prostate biopsy tissues from men with and without cancer.
Methods: Using an initial training set of 59 patients and a subsequent blinded validation set (116 subjects), we digitally imaged H&E biopsy slides utilizing the VectraTM platform. InForm2.1.1 software quantitatively measured features of epithelial and stroma. Non-tumor associated (NTA) cases underwent â‰¥2 previous negative biopsies and tumor associated (TA) cases all underwent radical prostatectomy. Additional imaging features were analyzed using custom Matlab software. Epithelial cell number was evaluated using immunohistochemistry.
Results: Epithelial to stromal area ratio is greater in TA compared to NTA tissues (0.95 versus 0.69, p=0.002) representing a decrease in stromal area. Epithelial to total area for TA versus NTA is higher (44.9% and 38.8% respectively; p=0.0006) generating a predictive AUC of 0.65 (95% CI 0.57-0.74). Independent validation confirms an increase in the epithelial to total area for TA (47.3%) versus NTA (41.8%; p=0.004), and the epithelial to stromal ratios (1.02 versus 0.81, p=0.004; AUC 0.62, 95% CI 0.54-0.70)(Figure). Further analysis demonstrates no changes in epithelial cell number (p=0.7). Other differences include increased epithelial thickness (3.11 versus 2.88 mm, p=0.006) and reduced gland lumen roundness (0.34 versus 0.38, p=0.001) in TA compared to NTA biopsies. Imaging of NTA tissues did not demonstrate differences with age (p=0.4).
Conclusions: This study is the first to report an increase in the epithelial to stromal area and other alterations detectable with computer-based imaging analysis in histologically benign prostate biopsies from men with prostate cancer. These changes may be useful in determining cancer presence.