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Authors

[:fr]C. Saillard[:],
[:fr]F. Delecourt[:],
[:fr]B. Schmauch[:],
[:fr]O. Moindrot[:],
[:fr]M. Svrcek[:],
[:fr]A. Bardier-Dupas[:],
[:fr]J-F. Emile[:],
[:fr]M. Ayadi[:],
[:fr]V. Rebours[:],
[:fr]L. de Mestier[:],
[:fr]P. Hammel[:],
[:fr]C. Neuzillet[:],
[:fr]J-B. Bachet[:],
[:fr]J. Iovanna[:],
[:fr]N. Dusetti[:],
[:fr]Y. Blum[:],
[:fr]M. Richard[:],
[:fr]Y. Kermezli[:],
[:fr]M. Zaslavskiy[:],
[:fr]P. Courtiol[:],
[:fr]A. Kamoun[:],

[:fr]

Abstract

Pancreatic ductal adenocarcinoma (PAC) is a highly heterogeneous and plastic tumor with different transcriptomic molecular subtypes that hold great prognostic and theranostic values. We developed PACpAInt, a multistep approach using deep learning models to determine tumor cell type and their molecular phenotype on routine histological preparation at a resolution enabling to decipher complete intratumor heterogeneity on a massive scale never achieved before. PACpAInt effectively identified molecular subtypes at the slide level in three validation cohorts and had an independent prognostic value. It identified an interslide heterogeneity within a case in 39% of tumors that impacted survival. Diving at the cell level, PACpAInt identified “pure” classical and basal-like main subtypes as well as an intermediary phenotype and hybrid tumors that co-carried both classical and basal-like phenotypes. These novel artificial intelligence-based subtypes, together with the proportion of basal-like cells within a tumor had a strong prognostic impact.

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