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Mechanosensitive TRPV4 immunohistochemistry improves deep learning-based classification of ductal carcinoma in situ beyond H&E morphology.

Overview

Authors: Janghyun Yoo1, Raghav Karthikeyan2,3, Kashi Kamat2,3, Christopher Chan2, Shabnam Samankan4, Elham Arbzadeh4, Arnold Schwartz4, Patricia S Latham4, Inhee Chung2,5
ORCID iDs: Inhee Chung
  1. Department of Physics and Astronomy, College of Natural Sciences, Seoul National University, Seoul, South Korea
  2. Department of Anatomy and Cell Biology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
  3. Thomas Jefferson Science and Technology High School, Alexandria, VA, USA
  4. Department of Pathology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
  5. Department of Biomedical Engineering, School of Engineering and Applied Science, George Washington University, Washington, DC, USA
Institutions: Seoul National University (South Korea); George Washington University (United States)
Journal: The journal of pathology. Clinical research, volume 12, issue 4, article e70106
Dates: received 20 December 2025; accepted 21 June 2026; published online 8 July 2026; in print July 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1002/2056-4538.70106 · PMID 42417209 · PMCID PMC13343292 · OpenAlex W7167739407
Open access: gold, a free copy (OpenAlex)
Status: code on request
Categories: histology / microscopy (modality), human (organism), other condition (population), clinical / translational (subfield)
Methods: Connectivity, Machine learning, Statistics, fMRI & imaging
Keywords: ductal carcinoma in situ, breast pathology, immunohistochemistry, TRPV4, deep learning, digital pathology, whole‐slide imaging, external validation, histopathologic classification, convolutional neural networks
MeSH: Biomarkers, Tumor*, Breast Neoplasms*, Carcinoma, Ductal, Breast*, Carcinoma, Intraductal, Noninfiltrating*, Deep Learning*, TRPV Cation Channels*, Female, Humans, Immunohistochemistry (* major topic)
Topic: AI in cancer detection (Artificial Intelligence, Computer Science), according to OpenAlex
Funding: National Cancer Institute; Technology Maturation Award from the George Washington University Technology Commercialization Office; GW Cancer Center Katzen Research Program; Elsa U. Pardee Foundation; NCI NIH HHS
Citations: not cited yet (Europe PMC); 38 references in the paper
Research resources: USA) using anti‐TRPV4 antibody RRID:AB_1143677, USA) Cooperative Human Tissue Network RRID:SCR_004446

Abstract

Ductal carcinoma in situ (DCIS) spans a biologic continuum from atypical ductal hyperplasia (ADH) to high‐grade lesions with variable risk of progression to invasive ductal carcinoma (IDC), yet morphologic assessment by hematoxylin and eosin (H&E) remains diagnostically limited, particularly at the benign versus ADH/low‐grade DCIS boundary. TRPV4, a mechanosensitive ion channel with pathology‐dependent subcellular localization in DCIS, offers a biologically motivated immunohistochemical (IHC) marker that may refine classification beyond routine H&E assessment. We tested whether deep learning models trained on TRPV4 IHC outperform H&E‐based models across the DCIS progression spectrum. We assembled a multi‐institutional cohort of H&E and TRPV4 IHC whole‐slide images from 108 patients, comprising an internal development cohort (n = 69), an external test cohort (n = 39), yielding 24,248 annotated tiles. Histopathological tiles from annotated regions were grouped into four ordered classes: normal/benign, ADH/low‐grade DCIS, high‐grade DCIS, and IDC. Xception and EfficientNet‐B0 convolutional neural networks were trained with patient‐level three‐fold cross‐validation on the development cohort and evaluated as ensembles on the external test cohort. On external patient‐level testing, H&E ensembles achieved macro‐F1 values of 0.43–0.44 and macro‐AUC values of 0.73–0.80, whereas TRPV4 IHC ensembles improved performance to macro‐F1 values of 0.68–0.72 and macro‐AUC values of 0.91–0.92, corresponding to a 54.5–67.4% relative improvement in patient‐level macro‐F1. Patient‐level per‐class analyses showed the largest AUC gains with TRPV4 IHC versus H&E for ADH/low‐grade DCIS (0.94–0.95 versus 0.61–0.70) and IDC (0.77–0.85 versus 0.61–0.69). Per‐class analyses showed the largest gains with TRPV4 IHC versus H&E for ADH/low‐grade DCIS (AUC, 0.83–0.84 versus 0.70–0.81) and IDC (AUC, 0.74–0.79 versus 0.65–0.66). These findings support TRPV4 IHC as a mechanistically grounded complement to H&E that improves patient‐level discrimination across the DCIS progression spectrum, with the strongest gains for ADH/low‐grade DCIS and IDC, in a pilot multi‐institutional setting.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

The paper's code and data availability statement is in the Data section.

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Data

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Data availability statement

De‐identified data and analysis code will be provided by the corresponding author upon reasonable request, subject to institutional policies and data use agreements.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 9 authors, 10 keywords, 9 MeSH terms, 5 funders, 35 references, 2 RRIDs.

Cite

This paper

Yoo, J., Karthikeyan, R., Kamat, K., Chan, C., Samankan, S., Arbzadeh, E., Schwartz, A., Latham, P. S., & Chung, I. (2026). Mechanosensitive TRPV4 immunohistochemistry improves deep learning-based classification of ductal carcinoma in situ beyond H&E morphology. The journal of pathology. Clinical research, 12(4), e70106. https://doi.org/10.1002/2056-4538.70106

BibTeX

@article{yoo2026mechanosensitive,
author = {Yoo, Janghyun and Karthikeyan, Raghav and Kamat, Kashi and Chan, Christopher and Samankan, Shabnam and Arbzadeh, Elham and Schwartz, Arnold and Latham, Patricia S and Chung, Inhee},
title = {{Mechanosensitive TRPV4 immunohistochemistry improves deep learning-based classification of ductal carcinoma in situ beyond H\&E morphology}},
journal = {The journal of pathology. Clinical research},
year = {2026},
month = jul,
volume = {12},
number = {4},
pages = {e70106},
publisher = {Wiley},
issn = {2056-4538},
doi = {10.1002/2056-4538.70106},
url = {https://doi.org/10.1002/2056-4538.70106},
pmid = {42417209},
pmcid = {PMC13343292}
}

RIS

TY - JOUR
AU - Yoo, Janghyun
AU - Karthikeyan, Raghav
AU - Kamat, Kashi
AU - Chan, Christopher
AU - Samankan, Shabnam
AU - Arbzadeh, Elham
AU - Schwartz, Arnold
AU - Latham, Patricia S
AU - Chung, Inhee
TI - Mechanosensitive TRPV4 immunohistochemistry improves deep learning-based classification of ductal carcinoma in situ beyond H&E morphology
T2 - The journal of pathology. Clinical research
J2 - J Pathol Clin Res
PY - 2026
DA - 2026/07/01
VL - 12
IS - 4
SP - e70106
SN - 2056-4538
PB - Wiley
DO - 10.1002/2056-4538.70106
UR - https://doi.org/10.1002/2056-4538.70106
LA - en
ER -

CSL-JSON

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