男性和女性乳腺癌的预后和治疗都依赖于雌激素受体 α (ERα) 和孕激素受体 (PR) 的表达来指导治疗。此前的研究表明，乳腺癌中ERα和PR存在性别特异性结合特征，与直觉相反的是，ERα表达在男性乳腺癌中比女性乳腺癌中更常见。我们假设这些差异可能具有人类观察者无法察觉的形态表现，但可以通过计算来阐明。为了研究这一点，我们使用 H 训练了针对 ERα 和 PR 的基于注意力的多实例学习预测模型

Breast cancer prognosis and management for both men and women are reliant upon estrogen receptor alpha (ERα) and progesterone receptor (PR) expression to inform therapy. Previous studies have shown that there are sex-specific binding characteristics of ERα and PR in breast cancer and, counterintuitively, ERα expression is more common in male than female breast cancer. We hypothesized that these differences could have morphological manifestations that are undetectable to human observers but could be elucidated computationally. To investigate this, we trained attention-based multiple instance learning prediction models for ERα and PR using H&E-stained images of female breast cancer from the Cancer Genome Atlas (TCGA) (n = 1085) and deployed them on external female (n = 192) and male breast cancer images (n = 245). Both targets were predicted in the internal (AUROC for ERα prediction: 0.86 ± 0.02, p < 0.001; AUROC for PR prediction = 0.76 ± 0.03, p < 0.001) and external female cohorts (AUROC for ERα prediction: 0.78 ± 0.03, p < 0.001; AUROC for PR prediction = 0.80 ± 0.04, p < 0.001) but not the male cohort (AUROC for ERα prediction: 0.66 ± 0.14, p = 0.43; AUROC for PR prediction = 0.63 ± 0.04, p = 0.05). This suggests that subtle morphological differences invisible upon visual inspection may exist between the sexes, supporting previous immunohistochemical, genomic, and transcriptomic analyses.© 2023. The Author(s).