A COMPARISON OF MOLECULAR- AND HISTOPATHOLOGICAL-DIAGNOSES OF RENAL TRANSPLANT INDICATION BIOPSIES
Bibliographic record
Abstract
Background: Kidney transplantation (KT) relies heavily on histologic examination of biopsies for identifying T cell mediated rejection (TCMR) and antibody mediated rejection (ABMR), which is problematic in terms of subjectivity, reproducibility, and even validity of the rules. Transplant medicine needs new diagnostic approaches to guide clinical management and prevent graft loss. Methods: This study was conducted as part of INTERCOMEX (The International Collaborative Microarray Study extension study), a prospective study that aimed to assess the feasibility of real time molecular microscope diagnostic system (MMDx) biopsy assessment by using microarrays. Biopsy samples in each center were immediately stabilized in RNAlater (Qiagen, Mississauga, Canada) and sent by courier to be processed (RNA extraction and labeling, microarray assessment, and normalization of the measurements with the reference set biopsy samples) and analyzed by using predefined algorithms. The classifier output is a score between 0.0 and 1.0, reflecting the probability that a biopsy is TCMR or ABMR. We assigned biopsies above a score of 0.1 as molecular TCMR and 0.2 as molecular ABMR.Results: Considering histology showing T-cell mediated rejection (TCMR), a total 23 patients consisted with histology positive, molecular score positive 6, histology positive, molecular score negative 7, histology negative, molecular score positive 3, and histology negative, molecular score negative 7. Thus in 7/13(54%) of biopsies called TCMR by histology did not have a molecular signal, and 3/9(33%) of biopsies with a molecular signal were not called TCMR by histology. All 9 biopsies with ABMR scores < 0.2 assessed as non-AMBR by histology. When the score was > 0.5, all 7 patients were assigned a diagnosis of ABMR in histologic features. 2 of 7 patients who had scores between 0.2 and 0.5 assessed as non-AMBR by histology. Conclusion: Molecular assessment is feasible and offers a useful new dimension in biopsy interpretation. Discrepancies between molecular scores and histology maybe be due to ambiguity in histologic diagnosis of TCMR.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".