Lymphoid Infiltration Assessment of the Tumor Margins in H&E Slides

Abstract: Lymphoid infiltration at tumor margins is a key prognostic marker in solid tumors, playing a crucial role in guiding immunotherapy decisions. Current assessment methods, heavily reliant on immunohistochemistry (IHC), face challenges in tumor margin delineation and are affected by tissue preservation conditions. In contrast, we propose a Hematoxylin and Eosin (H&E) staining-based approach, underpinned by an advanced lymphocyte segmentation model trained on a public dataset for the precise detection of CD3+ and CD20+ lymphocytes. In our colorectal cancer study, we demonstrate that our H&E-based method offers a compelling alternative to traditional IHC, achieving comparable results in many cases. Our method's validity is further explored through a Turing test, involving blinded assessments by a pathologist of anonymized curves from H&E and IHC slides. This approach invites the medical community to consider Turing tests as a standard for evaluating medical applications involving expert human evaluation, thereby opening new avenues for enhancing cancer management and immunotherapy planning.