Prognostic significance of mesothelin expression in colorectal cancer disclosed by area-specific four-point tissue micro
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ORIGINAL ARTICLE
Prognostic significance of mesothelin expression in colorectal cancer disclosed by area-specific four-point tissue microarrays Takehiro Shiraishi 1 & Eiji Shinto 1 & Ines P. Nearchou 2 & Hitoshi Tsuda 3 & Yoshiki Kajiwara 1 & Takahiro Einama 1 & Peter D. Caie 2 & Yoji Kishi 1 & Hideki Ueno 1 Received: 24 September 2019 / Revised: 17 January 2020 / Accepted: 13 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Mesothelin (MSLN) is a cell surface glycoprotein present in many cancer types. Its expression is generally associated with an unfavorable prognosis. This study examined the prognostic significance of MSLN expression in different areas of individual colorectal cancers (CRCs) using tissue microarrays (TMAs) by enrolling 314 patients with stage II (T3–T4, N0, M0) CRCs. Using formalin-fixed paraffin-embedded tissue blocks from patients, TMA blocks were constructed. Tissue core specimens were obtained from submucosal invasive front (Fr-sm), subserosal invasive front (Fr-ss), central area (Ce), and rolled edge (Ro) of each tumor. Using these four-point TMA sets, MSLN expression was immunohistochemically surveyed. The area-specific prognostic significance of MSLN expression was evaluated. A deep learning convolutional neural network algorithm was used for imaging analysis and evaluating our judgment’s objectivity. MSLN staining ratio was positively correlated between the manual and machine-learning analyses (r = 0.71). The correlation coefficient between Ro and Ce, Ro and Fr-sm, and Ro and Fr-ss was r = 0.63, r = 0.54, and r = 0.61, respectively. Disease-specific survival curves for the MSLN-positive and MSLNnegative groups in Fr-sm, Fr-ss, and Ro were significantly different (five-year survival rates 88.1% and 95.5% (P = 0.024), 85.0 and 96.2% (P = 0.0087), 87.8 and 95.5% (P = 0.051), and 77.9 and 95.8% (P = 0.046) for Fr-sm, Fr-ss, Ce, and Ro, respectively). The analysis performed using area-specific four-point TMAs clearly demonstrated that MSLN expression in stage II CRC was relatively homogeneous within tumors. Additionally, high MSLN expression showed or tended to show unfavorable prognostic significance regardless of the tumor area. Keywords Mesothelin . Colorectal cancer . Tissue microarray . Immunohistochemistry . Artificial intelligence . Deep learning
Abbreviations CI Confidence interval DSS Disease-specific survival HR Hazard ratio ROC Receiver operating characteristic TMA Tissue microarray EMT Epithelial mesenchymal transition This article is part of the Topical Collection on Quality in Pathology * Eiji Shinto [email protected] 1
Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-0042, Japan
2
Quantitative and Digital Pathology, School of Medicine, University of St. Andrews, St. Andrews KY16 9TF, UK
3
Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-0042, Japan
Introduction Colorectal cancer (CRC) cells emerge from the epithelial layer, and they prolife
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