Summary: The metastatic cancer of cervical lymph nodes presents complex shapes and poses significant challenges for doctors in determining its origin. We established a deep learning framework to predict the status of lymph nodes in patients with cervical lymphadenopathy (CLA) by hematoxylin and eosin (H&E) stained slides. This retrospective study utilized 1,036 cervical lymph node biopsy specimens at the First Affiliated Hospital of Sun Yat-Sen University (FAHSYSU). A multiple-instance learning algorithm designed for key region identification was applied, and cross-validation experiments were conducted in the dataset. Additionally, the model distinguished between primary lymphoma and metastatic cancer with high prediction accuracy. We also validated our model and other models on an external dataset. Our model showed better generalization and achieved the best results on both internal and external datasets. This algorithm offers an approach for evaluating cervical lymph node status before surgery, significantly aiding physicians in preoperative diagnosis and treatment planning.
