Artificial intelligence for cellular phenotyping diagnosis of nasal polyps by whole-slide imaging
Qingwu Wu,
Jianning Chen,
Yong Ren,
Huijun Qiu,
Lianxiong Yuan,
Huiyi Deng,
Yana Zhang,
Rui Zheng,
Haiyu Hong,
Yueqi Sun,
Xinyue Wang,
Xuekun Huang,
Chunkui Shao,
Haotian Lin,
Lanqing Han,
Qintai Yang
Affiliations
Qingwu Wu
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China; Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Jianning Chen
Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Yong Ren
Artificial Intelligence Innovation Center, Research Institute of Tsinghua, Pearl River Delta, Guangzhou 510735, China; Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China
Huijun Qiu
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Lianxiong Yuan
Department of Science and Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Huiyi Deng
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Yana Zhang
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Rui Zheng
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Haiyu Hong
Department of Otolaryngology-Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519020, China
Yueqi Sun
Department of Otorhinolaryngology-Head and Neck Surgery, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China
Xinyue Wang
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Xuekun Huang
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Chunkui Shao
Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
Haotian Lin
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China
Lanqing Han
Artificial Intelligence Innovation Center, Research Institute of Tsinghua, Pearl River Delta, Guangzhou 510735, China; Corresponding authors.
Qintai Yang
Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China; Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China; Corresponding author at: Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou 510630, China.
Background: artificial intelligence (AI) for cellular phenotyping diagnosis of nasal polyps by whole-slide imaging (WSI) is lacking. We aim to establish an AI chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0) to obtain the proportion of inflammatory cells for cellular phenotyping diagnosis of nasal polyps and to explore the clinical significance of different phenotypes of nasal polyps on the WSI. Methods: a total of 453 patients were enrolled in our study. For the development of AICEP 2.0, 179 patients (WSIs) were obtained from the Third Affiliated Hospital of Sun Yat-Sen University (3HSYSU) from January 2008 to December 2018. A total of 24,625 patches were automatically extracted from the regions of interest under a 400× HPF by Openslide and the number of inflammatory cells in these patches was counted by two pathologists. For the application of AICEP 2.0 in a prospective cohort, 158 patients aged 14–70 years old with chronic rhinosinusitis with nasal polyps (CRSwNP) who had undergone endoscopic sinus surgery at 3HSYSU from June 2020 to December 2020 were included for preoperative demographic characteristics. For the application of AICEP 2.0 in a retrospective cohort, 116 patients with CRSwNP who had undergone endoscopic sinus surgery from May 2016 to June 2017 were enrolled for the recurrence rate. The proportion of inflammatory cells of these patients on WSI was calculated by our AICEP 2.0. Findings: for AICEP 2.0, the mean absolute errors of the ratios of eosinophils, lymphocytes, neutrophils, and plasma cells were 1.64%, 2.13%, 1.06%, and 1.22%, respectively. The four phenotypes of nasal polyps were significantly different in clinical characteristics (including asthma, itching, sneezing, total IgE, peripheral eosinophils%, tissue eosinophils%, tissue neutrophils%, tissue lymphocytes%, tissue plasma cells%, and recurrence rate; P <0.05), but there were no significant differences in age distribution, onset time, total VAS score, Lund-Kennedy score, or Lund-Mackay score. The percentage of peripheral eosinophils was positively correlated with the percentage of tissue eosinophils (r = 0.560, P <0.001) and negatively correlated with tissue lymphocytes% (r = -0.489, P <0.001), tissue neutrophils% (r = -0.225, P = 0.005), and tissue plasma cells% (r = -0.266, P = 0.001) in WSIs.
