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Lin S, Samsoondar JP, Bandari E, Keow S, Bikash B, Tan D, Martinez-Acevedo J, Loggie J, Pham M, Wu NJ, Misra T, Lam VHK, Sansano I, Cecchini MJ. Digital Quantification of Tumor Cellularity as a Novel Prognostic Feature of Non-Small Cell Lung Carcinoma. Mod Pathol 2023; 36:100055. [PMID: 36788101 DOI: 10.1016/j.modpat.2022.100055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/01/2022] [Accepted: 11/19/2022] [Indexed: 01/11/2023]
Abstract
Non-small cell lung carcinoma is currently staged based on the size and involvement of other structures. Tumor size may be a surrogate measure of the total number of tumor cells. A recently revised reporting system for adenocarcinoma incorporates high-risk histologic patterns, which may have increased cellular density. Modern digital image analysis tools can be utilized to automate the quantification of cells. In this study, we tested the hypothesis that tumor cellularity can be used as a novel prognostic tool for lung cancer. Digital slides from The Cancer Genome Atlas lung adenocarcinoma (ADC) data set (n = 213) and lung squamous cell carcinoma (SCC) data set (n = 90) were obtained and analyzed using QuPath. The number of tumor cells was normalized with the surface area of the tumor to provide a measure of tumor cell density. Tumor cellularity was calculated by multiplying the size of the tumor with the cell density. Major histologic patterns and grade were compared with the tumor density of the lung ADC and lung SCC cases. The overall and progression-free survival were compared between groups of high and low tumor cellularity. High-grade histologic patterns in the ADC and SCC cases were associated with greater tumor densities compared with low-grade patterns. Cases with lower tumor cellularity had improved overall and progression-free survival compared with cases with higher cellularity. These results support tumor cellularity as a novel prognostic tool for non-small cell lung carcinoma that considers tumor stage and grade elements.
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Affiliation(s)
- Sherman Lin
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Joshua P Samsoondar
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Ela Bandari
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Samantha Keow
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Binit Bikash
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Djarren Tan
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Jacobo Martinez-Acevedo
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - John Loggie
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michelle Pham
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Nina J Wu
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Tanya Misra
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Victor H K Lam
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Irene Sansano
- Department of Pathology, Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
| | - Matthew J Cecchini
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada.
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