Computer-assisted subtyping and prognosis for non-small cell lung cancer patients with unresectable tumor.

Background: The histological classification or subtyping of non-small cell lung cancer is essential for systematic therapy decisions. Differentiating between the two main subtypes of pulmonary adenocarcinoma and squamous cell carcinoma highlights the considerable differences that exist in the prognosis of patient outcomes. Physicians rely on a pathological analysis to reveal these phenotypic variations that requires invasive methods, such as biopsy and resection sample, but almost 70% of tumors are unresectable at the point of diagnosis.

Method: A computational method that fuses two frameworks of computerized subtyping and prognosis was proposed, and it was validated against publicly available dataset in The Cancer Imaging Archive that consisted of 82 curated patients with CT scans. The accuracy of the proposed method was compared with the gold standard of pathological analysis, as defined by theInternational Classification of Disease for Oncology (ICD-O). A series of survival outcome test cases were evaluated using the Kaplan-Meier estimator and log-rank test (p-value) between the computational method and ICD-O.

Results: The computational method demonstrated high accuracy in subtyping (96.2%) and good consistency in the statistical significance of overall survival prediction for adenocarcinoma and squamous cell carcinoma patients (p < 0.03) with respect to its counterpart pathological subtyping (p < 0.02). The degree of reproducibility between prognosis taken on computational and pathological subtyping was substantial with an averaged concordance correlation coefficient (CCC) of 0.9910.

Conclusion: The findings in this study support the idea that quantitative analysis is capable of representing tissue characteristics, as offered by a qualitative analysis.