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Yi M, Zhan T, Rui H, Chervoneva I. Functional protein biomarkers based on distributions of expression levels in single-cell imaging data. Bioinformatics 2025; 41:btaf182. [PMID: 40257750 PMCID: PMC12070390 DOI: 10.1093/bioinformatics/btaf182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 04/01/2025] [Accepted: 04/19/2025] [Indexed: 04/22/2025] Open
Abstract
MOTIVATION The intra-tumor heterogeneity of protein expression is well recognized and may provide important information for cancer prognosis and predicting treatment responses. Analytic methods that account for spatial heterogeneity remain methodologically complex and computationally demanding for single-cell protein expression. For many functional proteins, single-cell expressions vary independently of spatial localization in a substantial proportion of the tumor tissues, and incorporation of spatial information may not affect the prognostic value of such protein biomarkers. RESULTS We developed a new framework for using the distributions of functional single-cell protein expression levels as cancer biomarkers. The quantile functions of single-cell expressions are used to fully capture the heterogeneity of protein expression across all cancer cells. The quantile index (QI) biomarker is defined as an integral of an unspecified function which may depend linearly or nonlinearly on a tissue-specific quantile function. Linear and nonlinear versions of QI biomarkers based on single-cell expressions of ER, Ki67, TS, and CyclinD3 were derived and evaluated as predictors of progression-free survival or high mitotic index in a large breast cancer dataset. We evaluated performance and demonstrated the advantages of nonlinear QI biomarkers through simulation studies. AVAILABILITY AND IMPLEMENTATION The associated R package Qindex is available at https://CRAN.R-project.org/package=Qindex and R package hyper.gam is available at https://github.com/tingtingzhan/hyper.gam. Examples of R code and detailed instructions could be found in vignette quantile-index-predictor (https://CRAN.R-project.org/package=hyper.gam/vignettes/applications.html#quantile-index-predictor).
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Affiliation(s)
- Misung Yi
- Department of Statistics & Data Science, College of Software and Convergence, Dankook University, Suji-gu, Gyeonggi-do 16890, Korea
| | - Tingting Zhan
- Division of Biostatistics & Bioinformatics, Department of Pharmacology, Physiology & Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Hallgeir Rui
- Division of Cancer Biology, Department of Pharmacology, Physiology & Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Inna Chervoneva
- Division of Biostatistics & Bioinformatics, Department of Pharmacology, Physiology & Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, United States
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Ghosh T, Baxter RM, Seal S, Lui VG, Rudra P, Vu T, Hsieh EW, Ghosh D. cytoKernel: Robust kernel embeddings for assessing differential expression of single cell data. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.16.608287. [PMID: 39229233 PMCID: PMC11370373 DOI: 10.1101/2024.08.16.608287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
High-throughput sequencing of single-cell data can be used to rigorously evlauate cell specification and enable intricate variations between groups or conditions. Many popular existing methods for differential expression target differences in aggregate measurements (mean, median, sum) and limit their approaches to detect only global differential changes. We present a robust method for differential expression of single-cell data using a kernel-based score test, cytoKernel. cytoKernel is specifically designed to assess the differential expression of single cell RNA sequencing and high-dimensional flow or mass cytometry data using the full probability distribution pattern. cytoKernel is based on kernel embeddings which employs the probability distributions of the single cell data, by calculating the pairwise divergence/distance between distributions of subjects. It can detect both patterns involving aggregate changes, as well as more elusive variations that are often overlooked due to the multimodal characteristics of single cell data. We performed extensive benchmarks across both simulated and real data sets from mass cytometry data and single-cell RNA sequencing. The cytoKernel procedure effectively controls the False Discovery Rate (FDR) and shows favourable performance compared to existing methods. The method is able to identify more differential patterns than existing approaches. We apply cytoKernel to assess gene expression and protein marker expression differences from cell subpopulations in various publicly available single-cell RNAseq and mass cytometry data sets. The methods described in this paper are implemented in the open-source R package cytoKernel, which is freely available from Bioconductor at http://bioconductor.org/packages/cytoKernel.
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Affiliation(s)
- Tusharkanti Ghosh
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ryan M Baxter
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Souvik Seal
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Victor G Lui
- Center for Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Pratyaydipta Rudra
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
| | - Thao Vu
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elena Wy Hsieh
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Debashis Ghosh
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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VanderDoes J, Marceaux C, Yokote K, Asselin-Labat ML, Rice G, Hywood JD. Using random forests to uncover the predictive power of distance-varying cell interactions in tumor microenvironments. PLoS Comput Biol 2024; 20:e1011361. [PMID: 38875302 PMCID: PMC11210873 DOI: 10.1371/journal.pcbi.1011361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 06/27/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024] Open
Abstract
Tumor microenvironments (TMEs) contain vast amounts of information on patient's cancer through their cellular composition and the spatial distribution of tumor cells and immune cell populations. Exploring variations in TMEs between patient groups, as well as determining the extent to which this information can predict outcomes such as patient survival or treatment success with emerging immunotherapies, is of great interest. Moreover, in the face of a large number of cell interactions to consider, we often wish to identify specific interactions that are useful in making such predictions. We present an approach to achieve these goals based on summarizing spatial relationships in the TME using spatial K functions, and then applying functional data analysis and random forest models to both predict outcomes of interest and identify important spatial relationships. This approach is shown to be effective in simulation experiments at both identifying important spatial interactions while also controlling the false discovery rate. We further used the proposed approach to interrogate two real data sets of Multiplexed Ion Beam Images of TMEs in triple negative breast cancer and lung cancer patients. The methods proposed are publicly available in a companion R package funkycells.
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Affiliation(s)
- Jeremy VanderDoes
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Claire Marceaux
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Australia
| | - Kenta Yokote
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Marie-Liesse Asselin-Labat
- Personalised Oncology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Australia
| | - Gregory Rice
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Jack D. Hywood
- Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
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Masotti M, Osher N, Eliason J, Rao A, Baladandayuthapani V. DIMPLE: An R package to quantify, visualize, and model spatial cellular interactions from multiplex imaging with distance matrices. PATTERNS (NEW YORK, N.Y.) 2023; 4:100879. [PMID: 38106614 PMCID: PMC10724356 DOI: 10.1016/j.patter.2023.100879] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/11/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023]
Abstract
A major challenge in the spatial analysis of multiplex imaging (MI) data is choosing how to measure cellular spatial interactions and how to relate them to patient outcomes. Existing methods to quantify cell-cell interactions do not scale to the rapidly evolving technical landscape, where both the number of unique cell types and the number of images in a dataset may be large. We propose a scalable analytical framework and accompanying R package, DIMPLE, to quantify, visualize, and model cell-cell interactions in the TME. By applying DIMPLE to publicly available MI data, we uncover statistically significant associations between image-level measures of cell-cell interactions and patient-level covariates.
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Affiliation(s)
- Maria Masotti
- University of Michigan, Department of Biostatistics, Ann Arbor, MI 48109, USA
| | - Nathaniel Osher
- University of Michigan, Department of Biostatistics, Ann Arbor, MI 48109, USA
| | - Joel Eliason
- University of Michigan, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI 48109, USA
| | - Arvind Rao
- University of Michigan, Department of Biostatistics, Ann Arbor, MI 48109, USA
- University of Michigan, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI 48109, USA
| | - Veerabhadran Baladandayuthapani
- University of Michigan, Department of Biostatistics, Ann Arbor, MI 48109, USA
- University of Michigan, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI 48109, USA
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Ehsani R, Jonassen I, Akslen LA, Kleftogiannis D. LOCATOR: feature extraction and spatial analysis of the cancer tissue microenvironment using mass cytometry imaging technologies. BIOINFORMATICS ADVANCES 2023; 3:vbad146. [PMID: 37881170 PMCID: PMC10597586 DOI: 10.1093/bioadv/vbad146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/02/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
Motivation Recent advances in highly multiplexed imaging have provided unprecedented insights into the complex cellular organization of tissues, with many applications in translational medicine. However, downstream analyses of multiplexed imaging data face several technical limitations, and although some computational methods and bioinformatics tools are available, deciphering the complex spatial organization of cellular ecosystems remains a challenging problem. Results To mitigate this problem, we develop a novel computational tool, LOCATOR (anaLysis Of CAncer Tissue micrOenviRonment), for spatial analysis of cancer tissue microenvironments using data acquired from mass cytometry imaging technologies. LOCATOR introduces a graph-based representation of tissue images to describe features of the cellular organization and deploys downstream analysis and visualization utilities that can be used for data-driven patient-risk stratification. Our case studies using mass cytometry imaging data from two well-annotated breast cancer cohorts re-confirmed that the spatial organization of the tumour-immune microenvironment is strongly associated with the clinical outcome in breast cancer. In addition, we report interesting potential associations between the spatial organization of macrophages and patients' survival. Our work introduces an automated and versatile analysis tool for mass cytometry imaging data with many applications in future cancer research projects. Availability and implementation Datasets and codes of LOCATOR are publicly available at https://github.com/RezvanEhsani/LOCATOR.
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Affiliation(s)
- Rezvan Ehsani
- Department of Informatics, Computational Biology Unit, University of Bergen, Bergen N-5020, Norway
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Bergen N-5020, Norway
| | - Inge Jonassen
- Department of Informatics, Computational Biology Unit, University of Bergen, Bergen N-5020, Norway
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Bergen N-5020, Norway
| | - Lars A Akslen
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Bergen N-5020, Norway
- Department of Pathology, Haukeland University Hospital, Bergen N-5020, Norway
| | - Dimitrios Kleftogiannis
- Department of Informatics, Computational Biology Unit, University of Bergen, Bergen N-5020, Norway
- Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, University of Bergen, Bergen N-5020, Norway
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Vu T, Seal S, Ghosh T, Ahmadian M, Wrobel J, Ghosh D. FunSpace: A functional and spatial analytic approach to cell imaging data using entropy measures. PLoS Comput Biol 2023; 19:e1011490. [PMID: 37756338 PMCID: PMC10561868 DOI: 10.1371/journal.pcbi.1011490] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 10/09/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Spatial heterogeneity in the tumor microenvironment (TME) plays a critical role in gaining insights into tumor development and progression. Conventional metrics typically capture the spatial differential between TME cellular patterns by either exploring the cell distributions in a pairwise fashion or aggregating the heterogeneity across multiple cell distributions without considering the spatial contribution. As such, none of the existing approaches has fully accounted for the simultaneous heterogeneity caused by both cellular diversity and spatial configurations of multiple cell categories. In this article, we propose an approach to leverage spatial entropy measures at multiple distance ranges to account for the spatial heterogeneity across different cellular organizations. Functional principal component analysis (FPCA) is applied to estimate FPC scores which are then served as predictors in a Cox regression model to investigate the impact of spatial heterogeneity in the TME on survival outcome, potentially adjusting for other confounders. Using a non-small cell lung cancer dataset (n = 153) as a case study, we found that the spatial heterogeneity in the TME cellular composition of CD14+ cells, CD19+ B cells, CD4+ and CD8+ T cells, and CK+ tumor cells, had a significant non-zero effect on the overall survival (p = 0.027). Furthermore, using a publicly available multiplexed ion beam imaging (MIBI) triple-negative breast cancer dataset (n = 33), our proposed method identified a significant impact of cellular interactions between tumor and immune cells on the overall survival (p = 0.046). In simulation studies under different spatial configurations, the proposed method demonstrated a high predictive power by accounting for both clinical effect and the impact of spatial heterogeneity.
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Affiliation(s)
- Thao Vu
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Souvik Seal
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Tusharkanti Ghosh
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Mansooreh Ahmadian
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Julia Wrobel
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Debashis Ghosh
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
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7
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Dayao MT, Trevino A, Kim H, Ruffalo M, D’Angio HB, Preska R, Duvvuri U, Mayer AT, Bar-Joseph Z. Deriving spatial features from in situ proteomics imaging to enhance cancer survival analysis. Bioinformatics 2023; 39:i140-i148. [PMID: 37387167 PMCID: PMC10311350 DOI: 10.1093/bioinformatics/btad245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
MOTIVATION Spatial proteomics data have been used to map cell states and improve our understanding of tissue organization. More recently, these methods have been extended to study the impact of such organization on disease progression and patient survival. However, to date, the majority of supervised learning methods utilizing these data types did not take full advantage of the spatial information, impacting their performance and utilization. RESULTS Taking inspiration from ecology and epidemiology, we developed novel spatial feature extraction methods for use with spatial proteomics data. We used these features to learn prediction models for cancer patient survival. As we show, using the spatial features led to consistent improvement over prior methods that used the spatial proteomics data for the same task. In addition, feature importance analysis revealed new insights about the cell interactions that contribute to patient survival. AVAILABILITY AND IMPLEMENTATION The code for this work can be found at gitlab.com/enable-medicine-public/spatsurv.
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Affiliation(s)
- Monica T Dayao
- Joint Carnegie Mellon University—University of Pittsburgh Ph.D. Program in Computational Biology, Pittsburgh, PA 15213, United States
- Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15213, United States
| | | | - Honesty Kim
- Enable Medicine, Menlo Park, CA 94025, United States
| | - Matthew Ruffalo
- Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15213, United States
| | | | - Ryan Preska
- Enable Medicine, Menlo Park, CA 94025, United States
| | - Umamaheswar Duvvuri
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA 15213, United States
| | - Aaron T Mayer
- Enable Medicine, Menlo Park, CA 94025, United States
| | - Ziv Bar-Joseph
- Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15213, United States
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213, United States
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Osher N, Kang J, Krishnan S, Rao A, Baladandayuthapani V. SPARTIN: a Bayesian method for the quantification and characterization of cell type interactions in spatial pathology data. Front Genet 2023; 14:1175603. [PMID: 37274781 PMCID: PMC10232864 DOI: 10.3389/fgene.2023.1175603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/25/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction: The acquisition of high-resolution digital pathology imaging data has sparked the development of methods to extract context-specific features from such complex data. In the context of cancer, this has led to increased exploration of the tumor microenvironment with respect to the presence and spatial composition of immune cells. Spatial statistical modeling of the immune microenvironment may yield insights into the role played by the immune system in the natural development of cancer as well as downstream therapeutic interventions. Methods: In this paper, we present SPatial Analysis of paRtitioned Tumor-Immune imagiNg (SPARTIN), a Bayesian method for the spatial quantification of immune cell infiltration from pathology images. SPARTIN uses Bayesian point processes to characterize a novel measure of local tumor-immune cell interaction, Cell Type Interaction Probability (CTIP). CTIP allows rigorous incorporation of uncertainty and is highly interpretable, both within and across biopsies, and can be used to assess associations with genomic and clinical features. Results: Through simulations, we show SPARTIN can accurately distinguish various patterns of cellular interactions as compared to existing methods. Using SPARTIN, we characterized the local spatial immune cell infiltration within and across 335 melanoma biopsies and evaluated their association with genomic, phenotypic, and clinical outcomes. We found that CTIP was significantly (negatively) associated with deconvolved immune cell prevalence scores including CD8+ T-Cells and Natural Killer cells. Furthermore, average CTIP scores differed significantly across previously established transcriptomic classes and significantly associated with survival outcomes. Discussion: SPARTIN provides a general framework for investigating spatial cellular interactions in high-resolution digital histopathology imaging data and its associations with patient level characteristics. The results of our analysis have potential implications relevant to both treatment and prognosis in the context of Skin Cutaneous Melanoma. The R-package for SPARTIN is available at https://github.com/bayesrx/SPARTIN along with a visualization tool for the images and results at: https://nateosher.github.io/SPARTIN.
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Affiliation(s)
- Nathaniel Osher
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Santhoshi Krishnan
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, United States
| | - Arvind Rao
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, United States
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Veerabhadran Baladandayuthapani
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
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Seal S, Ghosh D. MIAMI: mutual information-based analysis of multiplex imaging data. Bioinformatics 2022; 38:3818-3826. [PMID: 35748713 PMCID: PMC9344855 DOI: 10.1093/bioinformatics/btac414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/09/2022] [Accepted: 06/21/2022] [Indexed: 02/01/2023] Open
Abstract
MOTIVATION Studying the interaction or co-expression of the proteins or markers in the tumor microenvironment of cancer subjects can be crucial in the assessment of risks, such as death or recurrence. In the conventional approach, the cells need to be declared positive or negative for a marker based on its intensity. For multiple markers, manual thresholds are required for all the markers, which can become cumbersome. The performance of the subsequent analysis relies heavily on this step and thus suffers from subjectivity and lacks robustness. RESULTS We present a new method where different marker intensities are viewed as dependent random variables, and the mutual information (MI) between them is considered to be a metric of co-expression. Estimation of the joint density, as required in the traditional form of MI, becomes increasingly challenging as the number of markers increases. We consider an alternative formulation of MI which is conceptually similar but has an efficient estimation technique for which we develop a new generalization. With the proposed method, we analyzed a lung cancer dataset finding the co-expression of the markers, HLA-DR and CK to be associated with survival. We also analyzed a triple negative breast cancer dataset finding the co-expression of the immuno-regulatory proteins, PD1, PD-L1, Lag3 and IDO, to be associated with disease recurrence. We demonstrated the robustness of our method through different simulation studies. AVAILABILITY AND IMPLEMENTATION The associated R package can be found here, https://github.com/sealx017/MIAMI. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Souvik Seal
- Department of Biostatistics and Informatics, University of Colorado CU Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Debashis Ghosh
- Department of Biostatistics and Informatics, University of Colorado CU Anschutz Medical Campus, Aurora, CO 80045, USA
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