IAES
Inter
national
J
our
nal
of
Artificial
Intelligence
(IJ-AI)
V
ol.
15,
No.
4,
August
2026,
pp.
3761
3769
ISSN:
2252-8938,
DOI:
10.11591/ijai.v15.i4.pp3761-3769
r
3761
Deep
lear
ning
f
or
categorizing
micr
osatellite
stability
in
color
ectal
cancer
Sofyan
El
Idrissi,
Y
assine
Drider
,
Ikram
Ben
Abdel
Ouahab,
Mohammed
Bouhorma,
F
atiha
El
Ouaai
C3S
Laboratory
,
F
aculty
of
Sciences
and
T
echniques
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
etouan,
Morocco
Article
Inf
o
Article
history:
Recei
v
ed
Aug
3,
2024
Re
vised
Jun
10,
2026
Accepted
Jul
9,
2026
K
eyw
ords:
Biomark
ers
Colorectal
cancer
Con
v
olutional
neural
netw
orks
Deep
learning
Digital
P
athology
Histopathology
Microsatellite
instability
ABSTRA
CT
Cancer
remains
a
significant
global
health
challenge,
wit
h
its
incidence
rising
steadily
in
rec
ent
decades.
In
colorectal
cancer
(CRC),
microsatellite
instability
(MSI),
and
microsatellite
stability
(MSS)
are
important
biomark
ers
that
influence
treatment
decisions
and
patient
outcomes.
Accurate
MSI
classification
is
critical
b
ut
traditional
methods
can
be
costly
and
time-consuming.
This
study
e
xplores
the
potential
of
deep
learning
to
clas
sify
MSI
and
MSS
in
CRC.
A
lar
ge
dataset
of
CRC
patients
with
confirmed
MSI
and
MSS
status
w
as
utilized,
obtained
through
standard
testing
images.
Deep
learning
models
were
applied
to
histopathological
images,
analyzing
tissue
features
from
digital
slides.
Con
v
olutional
neural
netw
ork
(CNN)
and
residual
netw
ork
(ResNet)-18
models
demonstrated
hi
gh
accurac
y
in
distinguishing
between
MSI
and
MS
S
CRCs.
The
best-performing
model,
which
inte
grated
genomic
and
histopathological
data,
achie
v
ed
an
area
under
the
curv
e
(A
UC)
recei
v
er
operating
characteristic
(R
OC)
of
0.85,
indicating
strong
discrimination
capability
.
The
findi
ngs
suggest
that
deep
learning
could
be
a
v
aluable
tool
for
clinical
decision-making
and
personalized
medicine
in
CRC.
This
is
an
open
access
article
under
the
CC
BY
-SA
license
.
Corresponding
A
uthor:
Sofyan
El
Idrissi
C3S
Laboratory
,
F
aculty
of
Sciences
and
T
echniques
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi
T
etouan,
Morocco
Email:
idrissisofyan38@gmail.com
1.
INTR
ODUCTION
Colorectal
cancer
(CRC)
remains
a
for
midable
global
health
challenge,
currently
rank
ed
as
the
t
hird
most
pre
v
alent
malignanc
y
and
the
second
leading
cause
of
cancer
-related
mortality
w
orldwide
[1].
Originating
within
the
epithelial
cells
of
the
colon
or
rectum,
CRC
typically
arises
from
a
sequential
accumulation
of
genetic
and
epigenetic
alterations
that
dri
v
e
uncontroll
ed
cellular
proliferation
[2].
These
pathological
changes
often
manifest
initially
as
benign
polyps
which,
o
v
er
time,
may
transform
into
malignant
neoplasms
capable
of
in
v
ading
adjacent
tissues
or
metastasizing
to
dist
ant
or
g
ans
via
the
lymphatic
and
circulatory
systems,
thereby
se
v
erely
compromising
patient
prognosis
[3].
The
biological
heterogeneity
of
CRC
necessitates
precise
molecular
characterization
to
guide
clinical
management.
While
modifiable
lifestyle
f
actors,
including
sedentary
beha
vior
and
diets
high
in
processed
meats,
interact
with
non-modifiable
risks
such
as
aging
to
influence
disease
incidence
[4],
contemporary
oncology
increasingly
relies
on
genomic
biomark
ers
to
na
vig
ate
the
substantial
economic
and
ph
ysiological
b
urdens
of
long-term
treatment
[5].
A
fundamental
molecular
di
stinction
in
CRC
is
the
status
of
microsatellite
stability
(
MSS).
Approximately
15%
of
cases
e
xhibit
microsatellite
instability
(MSI),
a
condition
resulting
from
a
deficient
DN
A
mismatch
repair
(dMMR)
system
[6].
MSI-H
tumors
are
characterized
by
a
high
frequenc
y
of
mutations
J
ournal
homepage:
http://ijai.iaescor
e
.com
Evaluation Warning : The document was created with Spire.PDF for Python.
3762
r
ISSN:
2252-8938
in
short,
repetiti
v
e
DN
A
sequences,
leading
to
a
“h
ypermutated”
genomic
profile.
Histologically
,
these
tumors
often
present
with
poor
dif
ferentiation
and
a
dense
infiltration
of
tumor
-infiltrating
lymphoc
ytes
(TILs)
[7].
This
high
tumor
mutational
b
urden
(TMB)
generates
immunogenic
neoantigens
that
render
MSI-H
patients
e
xceptionally
responsi
v
e
to
immune
checkpoint
inhibitors
(ICIs),
s
uch
as
pembrolizumab
and
ni
v
olumab,
despite
their
frequent
resistance
to
con
v
entional
chemotherap
y
[8],
[9].
Con
v
ersely
,
MSS
tumors
often
described
as
“immune-cold”,
e
xhibit
lo
w
mutational
profiles
and
sparse
T
-cell
infiltration,
making
them
intrinsically
resistant
to
single-agent
immunotherap
y
[10].
These
tumors
are
typically
dri
v
en
by
chromosomal
instability
,
in
v
olving
mutations
in
oncogenes
such
as
KRAS
and
tumor
suppressors
lik
e
TP53
[11].
F
or
these
patients,
clinical
strate
gies
focus
on
c
ytotoxic
chemotherap
y
combined
with
tar
geted
therapies
directed
at
epidermal
gro
wth
f
act
or
receptor
(EGFR)
or
v
ascular
endothelial
gro
wth
f
actor
(VEGF)
pathw
ays
[12],
[13].
While
the
distinction
between
MSI
and
MSS
is
critical
for
optimizing
survi
v
al
and
treatment
cost-ef
fecti
v
eness
[14],
gold-standard
diagnostic
methods
lik
e
immunohistochemistry
(IHC)
or
polymerase
chain
reaction
(PCR)
are
often
resource-intensi
v
e,
time-consuming,
and
require
specialized
pathology
e
xpertise.
R
ecent
breakthroughs
in
digital
pathology
suggest
that
deep
learning
can
potentially
predict
these
molecular
biomark
ers
directly
from
standard
hematoxylin
and
eosin
(H&E)
stained
slides
[15].
Despite
these
adv
ancements,
a
significant
g
ap
remains
in
the
literature
re
g
arding
the
de
v
elopment
of
lo
w-cost,
automated
MSI/MSS
classifiers
that
are
rigorously
v
alidated
on
lar
ge-scale
cohorts
such
as
the
Cancer
Genome
Atlas
(TCGA).
This
study
utilizes
deep
learning
o
v
er
c
o
n
v
entional
statistical
methods
due
to
its
superior
ca
p
a
city
for
hierarchical
feature
e
xtraction,
enabling
the
detect
ion
of
subtle
morphological
patterns
in
histology
images
that
e
v
ade
human
perception.
The
primary
objecti
v
es
of
this
research
ar
e
to
design
a
customized
con
v
olutional
neural
netw
ork
(CNN)
architecture
optimized
for
CRC
screening,
conduct
a
comparati
v
e
performance
e
v
aluation
ag
ainst
the
established
residual
netw
ork
(ResNet)-18
benchmark,
and
assess
the
clinical
feasibility
of
these
models
as
automated
decision-support
tools
for
oncologists.
2.
RELA
TED
W
ORKS
Although
clinically
defined
by
its
anatomical
origin,
CRC
is
a
highly
genetically
heterogeneous
disease.
This
molecular
di
v
ersity
influences
tumor
beha
vior
,
treatment
response,
and
patient
outcomes.
Despite
this
v
ariability
,
s
tandard
chemotherap
y
protocols,
typically
FOLFO
X
or
FOLFIRI
combined
with
tar
geted
agents
are
often
applied
uniformly
,
with
limited
consideration
of
indi
vidual
pharmacogenetic
v
ariations
and
molecular
characteris
tics.
Adjuv
ant
management
remains
primarily
dictated
by
tumor
stage.
The
pi
v
otal
MOSAIC
study
established
that
the
addit
ion
of
oxaliplatin
to
5-fluorouracil
(5-FU)
significantly
reduces
recurrence
risk
in
stage
II
and
III
disease
[16],
demonstrating
that
early-stage
patients
can
deri
v
e
considerable
curati
v
e
benefit.
W
ithin
this
frame
w
ork,
MSI
status
has
emer
ged
as
a
critical
predicti
v
e
mark
er
for
chemotherap
y
ef
ficac
y
.
While
the
oxaliplatin/5-FU
combination
is
the
established
adjuv
ant
standard
for
resected
stage
III
cancers,
the
MSI
phenotype
is
historically
associated
with
intrinsic
resistance
to
fluorop
yrimidine
monotherap
y
.
Pooled
analyses
of
randomized
trials
confirm
t
hat
while
MSI
patients
often
e
xhibit
prolonged
survi
v
al,
the
y
deri
v
e
no
benefit
from
adjuv
ant
5-FU
alone;
in
f
act,
potential
deleterious
ef
fects
ha
v
e
been
observ
ed
in
stage
II
disease.
Ho
we
v
er
,
the
inte
gration
of
oxaliplatin
has
been
sho
wn
to
o
v
ercome
this
resistance,
restoring
therapeutic
ef
ficac
y
specifically
for
stage
III
tumors
[17]-[19].
Furthermore,
findings
from
the
IDEA
international
collaborati
v
e
study
ha
v
e
refined
the
duration
and
modalities
of
t
hese
oxaliplatin-based
re
gimens
for
stage
III
patients
[20].
In
the
metastatic
setting,
distinguishing
between
MSS
and
MSI
phenotypes
is
a
fundamental
c
riterion
for
therapeutic
orientation.
P
atients
with
metastatic
MSI
cancer
are
no
w
primary
candidates
for
immune
checkpoint
blockade
(ICB)
using
anti-PD-1
or
anti-CTLA-4
antibodies
[21].
This
immunotherap
y
protocol
is
highly
ef
fecti
v
e
in
MSI-H
CRC
b
ut
remains
lar
gely
inef
fecti
v
e
in
MSS
cases
[22].
Consequently
,
clinical
guidelines,
such
as
the
French
Na
tional
Digesti
v
e
Cancer
Thesaurus
(TNCD),
recommend
adjuv
ant
chemotherap
y
(fluorop
yrimidine
+
oxaliplatin)
for
stage
III
MSI
tumors,
while
generally
omitting
adjuv
ant
treatment
for
stage
II
MSI
tumors
unless
high-risk
features,
such
as
pT4b
status,
are
present
[10].
While
the
MSI/MSS
phenotype
can
be
identified
through
con
v
entional
IHC
or
genetic
analysis
[23],
these
tests
are
often
e
xpensi
v
e
or
una
v
ailable
in
resource-constrained
re
gions,
lea
ding
to
suboptimal
screening.
Notably
,
MSI-H
CRCs
e
xhibit
distinct
histomorphological
features
compared
to
MSS
counterparts
[24].
This
morphological
di
v
er
gence
has
pa
v
ed
the
w
ay
for
deep
learning
algorithms
to
analyze
histopathological
images
for
survi
v
al
prediction
[25],
metastasis
detection
[26],
and
precise
histological
grading
[27],
[28].
Int
J
Artif
Intell,
V
ol.
15,
No.
4,
August
2026:
3761–3769
Evaluation Warning : The document was created with Spire.PDF for Python.
Int
J
Artif
Intell
ISSN:
2252-8938
r
3763
Recent
research
increasingly
demonstrates
that
deep
learning
model
s
can
bridge
the
g
ap
be
tween
histological
patterns
and
underlying
genomic
mutations
[29].
F
or
instance,
Kather
et
al
.
[30]
pro
v
ed
the
ef
fecti
v
eness
of
predicting
MSI
status
directly
from
H&E-stained
slides
in
g
astrointestinal
cancers,
a
finding
supported
by
the
interacti
v
e
HistomicsML
system
[31]
and
subsequent
studies
[32].
Furthermore,
K
e
et
al
.
[33]
utilized
high-performance
computing
(NVIDIA
T
esla
V100)
to
achie
v
e
an
MSI
prediction
accurac
y
of
87%,
while
Lee
et
al
.
[24]
estimated
that
up
to
40%
of
CRC
slides
could
be
ef
fecti
v
ely
screened
via
deep
learning
without
molecular
testing.
Adv
anced
models
such
as
MSINet
ha
v
e
achie
v
ed
an
area
under
the
curv
e
-
recei
v
er
o
pe
rating
characteristic
(A
UC-R
OC)
of
0.931
[34],
and
artificial
intelligence
(AI)-based
stratification
has
sho
wn
superior
results
in
cross-
v
a
lidation
with
an
area
under
the
recei
v
er
operating
characteristic
(A
UR
OC)
of
0.86
[35].
This
progress
is
mirrored
in
consensus
molecular
subtype
(CMS)
classification
[36]
and
the
inte
gration
of
se
gment
an
ything
model
(SAM)
with
deep
learning,
which
has
further
refined
the
se
gmentation
and
classification
of
MSI,
un
v
eiling
its
full
clinical
significance
in
contemporary
CRC
management
[37].
3.
METHODS
3.1.
Dataset
TCGA
initiati
v
e
pro
vides
comprehensi
v
e
molecular
portraits
of
v
arious
malignancies,
notably
including
the
colon
adenocarcinoma
(CO
AD)
cohort.
These
multi-omic
datasets
enable
the
prediction
of
MSI
status
by
inte
grating
molecular
profiles,
dif
ferential
gene
e
xpression,
and
DN
A
meth
ylation
patterns
[38].
F
or
this
study
,
the
dataset
consists
of
high-resolution
digital
pathology
slides
processed
into
standardized
JPEG
tiles,
capturing
the
distinct
morphological
features
associated
with
MSI-MUT
and
MSS
phenotypes.
The
data
preprocessing
pipeline
w
as
engineered
to
structure
and
partition
these
image
tiles
into
three
distinct
subsets:
training
(60%),
v
alidation
(25%),
and
testing
(15%).
T
o
miti
g
ate
selection
bi
as
and
ensure
statistical
representati
v
eness,
the
allocation
process
utilizes
a
randomized
shuf
fling
of
filenames
prior
to
distrib
ution.
The
dataset
e
xhibits
a
class
distrib
ution
of
39.02%
for
MSI-MUT
JPEG
and
60.98%
for
MSS
JPEG,
reflecting
the
inherent
pre
v
alence
v
ariance
found
in
clinical
populations.
T
o
maintain
data
inte
grity
during
training,
these
subsets
are
processed
through
the
torchvision.datasets.
ImageF
older
class,
with
images
resized
and
normalized
to
align
with
the
input
requirements
of
the
deep
learning
architectures.
Figure
1
illustrates
representati
v
e
sample
images
e
xtracted
from
the
dataset,
highlighting
the
te
xtural
and
cellular
di
v
ersities
between
the
tw
o
molecular
subtypes.
This
figure
displaying
representati
v
e
patches
for
both
MSI
and
MSS
classes.
Figure
1.
Sample
histological
images
from
the
dataset
3.2.
Deep
lear
ning
models
CNNs
stand
tall
as
a
pi
v
otal
architecture,
particularly
in
tasks
related
to
image
recogni
tion,
classification,
and
e
v
en
in
certain
aspects
of
natural
language
processing.
The
ef
ficienc
y
of
CNNs
can
be
attrib
uted
to
their
core
elements,
each
playing
a
distinct
role
in
information
e
xtraction
and
abstraction
within
the
netw
ork.
Here,
this
study
use
the
fundamental
components
of
CNNs:
input
dimension,
con
v
olution
layer
,
pooling
layer
,
fully
connected
layer
,
and
output.
The
complete
architecture
of
the
proposed
CNN
model
is
illustrated
in
Figure
2.
ResNet-18
is
a
pi
v
otal
CNN
architecture
that
addresses
the
v
anishing
gradient
problem
through
the
inte
gration
of
residual
learning
[39].
By
utilizing
shortcut
connections,
or
skip
connections,
the
netw
ork
ef
fecti
v
ely
performs
identity
mapping,
allo
wing
gradients
to
bypass
intermediate
layers
and
f
acilitating
the
optimization
of
deeper
s
tructures.
The
ResNet-18
v
ariant
specific
ally
emplo
ys
a
balanced
configuration
of
18
deep
la
y
e
rs,
comprising
an
initial
7
7
con
v
olution
follo
wed
by
four
stages
of
residual
blocks,
each
containing
tw
o
3
3
con
v
olutional
layers
[40],
[41].
This
architecture
terminates
with
a
global
a
v
erage
pooling
layer
and
a
fully
connected
softmax
classifier
.
While
deeper
iterations
lik
e
ResNet-50
or
ResNet-101
of
fer
higher
capacity
,
ResNet-18
remains
a
standard
benchmark
in
computer
vision
due
to
its
Deep
learning
for
cate
gorizing
micr
osatellite
stability
in
color
ectal
cancer
(Sofyan
El
Idrissi)
Evaluation Warning : The document was created with Spire.PDF for Python.
3764
r
ISSN:
2252-8938
optimal
tra
de-of
f
between
representat
i
v
e
po
wer
and
computational
ef
ficienc
y
,
making
it
particula
rly
suitable
for
resource-constrained
en
vironments
and
real-time
inference
tasks.
The
detailed
structure
of
the
pre-trained
ResNet-18
model
is
illustrated
in
Figure
3.
Figure
2.
Schematic
diagram
of
the
CNN
architecture
used
for
MSI/MSS
classification
Figure
3.
Architecture
of
the
pre-trained
ResNet-18
model
[39]
F
or
the
e
xperimental
implementation,
the
torchvision
library
in
Python
is
le
v
eraged
to
preprocess
and
load
the
TCGA
dataset.
Specifically
,
an
or
g
anized
data
structure
is
established
using
the
ImageF
older
class,
while
the
T
oT
ensor
transformation
standardizes
the
image
inputs.
T
o
ensure
a
balanced
representation
across
all
cate
gories,
class
distrib
utions
are
rigorously
analyzed
by
it
erating
o
v
er
class
indices
and
quantifying
image
counts
for
each
respecti
v
e
label.
The
core
architecture
utilizes
the
ResNet-18
model
tailored
for
the
TCGA
data.
During
e
xperimentation,
e
xtensi
v
e
h
yperparameter
tuning
is
performed
to
optimize
model
fit;
v
ariations
include
adjustments
to
the
number
and
type
of
layers,
k
ernel
sizes
(ranging
from
3
3
to
7
7
),
padding,
and
pooling
strate
gies
(max
and
a
v
erage
pooling).
Furthermore,
the
impact
of
ReLU
acti
v
ation,
v
arying
learning
rates
(
0
:
001
to
0
:
1
),
and
dropout
rates
(
0
:
2
to
0
:
5
)
is
e
xplored
alongside
se
v
eral
optimizers,
including
stochastic
gradient
descent
(SGD),
adapti
v
e
moment
estimation
(Adam),
and
root
mean
square
propag
ation
(RMSprop)
and
re
gularization
techniques
(
L
1
and
L
2
).
The
TCGA
database
is
partitioned
into
60%
for
training,
25%
for
v
alidation,
and
15%
f
o
r
testing.
Performance
is
quantified
using
a
comprehensi
v
e
suite
of
e
v
aluation
metrics,
including
accurac
y
,
precision,
recall,
F1-score,
and
the
A
UC.
Additionally
,
both
standard
and
normalized
confusion
matrices
are
analyzed
to
pro
vide
a
granular
assessment
of
classific
ation
performance
and
to
f
acilitate
comparati
v
e
benchmarking
with
e
xisting
literature.
Computational
e
xperiments
are
conduct
ed
on
a
professional
hardw
are
en
vironment
featuring
an
NVIDIA
Quadro
T2000
mobile
GPU
with
4
GB
GDDR5
memory
.
This
setup
is
augmented
by
Google
Colab
Pro
sessions,
pro
viding
access
to
cloud-based
T4
GPU
resources
for
more
intensi
v
e
processing
requirements.
4.
RESUL
TS
AND
DISCUSSION
The
primary
objecti
v
e
of
this
research
w
as
to
e
v
aluate
the
ef
ficac
y
of
deep
learning
architectures
in
accurately
discriminating
between
MSI
and
MSS
molecular
subtypes
in
CRC
histology
.
The
e
xperimental
frame
w
ork
compared
the
performance
of
a
transfer
-learning-based
ResNet-18
benchmark
ag
ainst
a
proposed
Int
J
Artif
Intell,
V
ol.
15,
No.
4,
August
2026:
3761–3769
Evaluation Warning : The document was created with Spire.PDF for Python.
Int
J
Artif
Intell
ISSN:
2252-8938
r
3765
custom
CNN
architecture
specifically
optimized
for
high-throughput
histopathological
tile
analysis.
The
empirical
results,
as
detailed
in
T
able
1,
demonstrate
that
the
proposed
CNN
significantly
outperforms
the
ResNet-18
model
across
all
e
v
aluated
statistical
dimensions.
Specifically
,
the
custom
archit
ecture
achie
v
ed
an
accurac
y
of
87.51%
and
an
A
UC-R
OC
of
0.8553,
representing
a
substantial
impro
v
ement
o
v
er
the
ResNet-18
baseline,
which
yielded
an
accurac
y
of
69.74%
a
nd
an
A
UC
of
0.6751.
Furthermore,
the
F1-score
of
0.9023
achie
v
ed
by
the
proposed
model
confirms
its
rob
ust
capabi
lity
to
maintain
predicti
v
e
equilibrium,
whereas
ResNet-18
e
xhibited
a
mark
ed
susce
p
t
ibility
to
the
majority
class
bias
inherent
in
unbalanced
histopathological
datasets.
T
able
1.
Ev
aluation
metrics
of
ResNet-18
and
proposed
CNN
models
Metric
ResNet-18
Proposed
CNN
Confusion
matrix
29280
21846
17695
61886
39187
12012
4395
75838
A
UC
score
0.6751
0.8553
Accurac
y
0.6974
0.8751
Precision
0.7390
0.8632
Recall
0.7776
0.9452
F1-score
0.7578
0.9023
A
granular
analysis
of
the
confusion
matrices,
illustrated
in
Figure
4,
re
v
eals
critical
insights
into
the
clinical
reliabilit
y
and
applicability
of
these
models.
While
ResNet-18
successfully
identified
29,280
true
positi
v
e
MSI
samples,
it
w
as
characterized
by
a
high
f
alse-ne
g
ati
v
e
rate,
misclassifying
17,695
MSI
cases
as
MSS.
From
a
clinical
perspecti
v
e,
such
omissions
a
re
highly
detrimental
,
as
the
y
could
pote
ntially
depri
v
e
patients
of
life-sa
ving
immunot
herap
y
.
In
contrast,
the
proposed
CNN
model
drastically
mitig
ated
these
errors
by
correctly
identifying
39,187
MSI
samples
and
reducing
f
alse
ne
g
ati
v
es
to
4,395.
This
refinement
is
most
e
vident
in
the
recall
(sensiti
vity)
metric,
which
sur
ged
from
77.76%
with
ResNet-18
to
94.52%
with
the
proposed
architecture.
Gi
v
en
that
high
sensiti
vity
is
a
non-ne
gotiable
prerequisite
for
diagnostic
screening
tools,
these
results
suggest
that
the
proposed
CNN
architecture
of
fers
a
more
viable
pathw
ay
for
assisting
pathologists
in
identifying
patients
who
w
ould
benefit
from
immune
checkpoint
inhibitors,
striking
a
superior
balance
between
representati
v
e
po
wer
and
computational
ef
ficienc
y
.
Figure
4.
Normalized
confusion
matrix
for
MSI/MSS
classification,
illustrating
the
prediction
accurac
y
across
both
classes
T
o
conte
xtualize
the
findings
within
the
contemporary
research
landscape,
this
study
conducted
a
comparati
v
e
analysis
with
prominent
studies
published
between
2019
a
nd
2024.
The
results
align
closely
with
the
foundational
e
vidence
pro
vided
by
Kather
et
al
.
[30],
who
esta
blished
the
baseline
feasibility
of
deep
learning
for
MSI
prediction
with
an
A
UC
of
approximately
0.84.
Notably
,
the
proposed
CNN
slightly
surpasses
this
benchmark
(A
UC
0.855),
reinforcing
the
premise
that
streamlined,
purpose-b
uilt
architectures
can
match
or
e
xceed
the
performance
of
massi
v
e
pre-trained
netw
orks
when
optimized
for
specific
Deep
learning
for
cate
gorizing
micr
osatellite
stability
in
color
ectal
cancer
(Sofyan
El
Idrissi)
Evaluation Warning : The document was created with Spire.PDF for Python.
3766
r
ISSN:
2252-8938
histopathological
tasks.
Recent
architect
ural
strate
gies
ha
v
e
further
di
v
ersified
this
field.
F
or
instance,
while
Y
amashita
et
al
.
[34]
demonstrated
the
ef
ficac
y
of
MobileNetV2
and
ResNet
v
ariants,
the
study
highlights
that
a
custom
CNN
can
achie
v
e
superior
sensiti
vity
without
the
prohibiti
v
e
computational
o
v
erhead
associated
with
deeper
netw
orks.
Similarly
,
Du
et
al
.
[42]
introduced
a
dual-scal
e
information
approach
to
enhance
predicti
v
e
precision.
While
their
multi-scale
methodology
of
fers
high
granularity
,
our
patch-based
CNN
achie
v
es
a
highly
competiti
v
e
F1-score
(0.90)
through
a
significantly
more
ef
ficient
implementation
pipeline.
Furthermore,
the
methodology
of
fers
a
distinct
contrast
to
the
c
omple
x
classification
techniques
described
in
recent
literature.
The
findings
di
v
er
ge
from
the
tw
o-stage
frame
w
ork
presented
by
Lee
et
al
.
[43],
which
necessitates
a
primary
tumor
se
gmentation
step
follo
wed
by
an
Inception-ResNet-V2
classifier
.
Although
Lee
et
al
.
[43]
reported
impro
v
ed
F1-scores
at
20
magnification,
the
model
maintains
consistent
performance
across
the
dataset
without
the
prerequisite
of
computationally
e
xpensi
v
e
pre-se
gmentation.
Finally
,
compared
to
the
kno
wledge
distillation
model
proposed
by
K
e
et
al
.
[44],
which
focuses
on
intricate
patch-le
v
el
sorting,
the
end-to-end
CNN
approach
f
acilitates
a
more
direct
and
seamless
clinical
w
orkflo
w
for
slide
cate
gorization.
5.
CONCLUSION
Ov
erall,
this
study
places
a
particular
emphasis
on
CRC,
a
leading
cause
of
cancer
-related
morbidity
and
mortality
,
to
delv
e
into
the
epidemiological
patterns,
risk
f
actors,
and
adv
ancements
in
diagnosis
and
treatment.
By
e
xploring
the
potential
of
deep
learning
models
for
cate
gorizing
MSI
and
MSS
in
CRC,
this
study
demonstrated
the
capability
of
deep
learning
models
to
accurately
discriminate
between
MSI
and
MSS
in
the
case
of
CRC.
This
study
has
limitations,
pri
marily
the
class
imbalance
(MSS
predominance)
and
the
reliance
solely
on
the
TCGA
dataset.
Consequently
,
e
xternal
v
alidation
on
independent
cohorts
is
required
to
rule
out
site-specific
biases
and
confirm
generalizability
.
Future
w
ork
will
also
incorporate
e
xplainability
techniques
(e.g.,
gradient-weighted
class
acti
v
ation
mapping
(Grad-CAM))
to
visualize
the
histological
features
dri
ving
the
model’
s
predictions,
thereby
enhancing
clinical
trust.
Further
research
is
w
arranted
to
v
alidate
actual
findings
in
lar
ge,
prospecti
v
e
clinical
trials
and
address
potential
challenges.
Inte
grating
interpretable
models
and
addressing
potential
biases
are
crucial
ne
xt
steps.
The
future
w
orks
include
also:
addressing
potential
biases
and
enhancing
model
interpretability
are
essential
for
ethical
considerations.
Exploration
of
alternati
v
e
deep
learning
architectures
and
data
augmentation
techniques
could
further
impro
v
e
performance.
Ne
v
ertheless,
this
study
pro
vides
compelling
e
vidence
for
the
t
ransformati
v
e
potential
of
deep
learning
in
enhancing
CRC
diagnosis
and
management,
ultimately
contrib
uting
to
impro
v
ed
patient
outcomes.
FUNDING
INFORMA
TION
This
research
recei
v
ed
no
specific
grant
from
an
y
funding
agenc
y
in
the
public,
commercial,
or
not-for
-profit
sectors.
A
UTHOR
CONTRIB
UTIONS
ST
A
TEMENT
This
journal
uses
the
Contrib
utor
Roles
T
axonomy
(CRediT)
to
recognize
indi
vidual
author
contrib
utions,
reduce
authorship
disputes,
and
f
acilitate
collaboration.
Name
of
A
uthor
C
M
So
V
a
F
o
I
R
D
O
E
V
i
Su
P
Fu
Sofyan
El
Idrissi
X
X
X
X
X
X
X
X
Y
assine
Drider
X
X
X
X
X
X
X
Ikram
Ben
Abdel
Ouahab
X
X
X
X
X
X
X
X
X
Mohammed
Bouhorma
X
X
X
X
X
X
F
atiha
El
Ouaai
X
X
X
X
X
C
:
C
onceptualization
I
:
I
n
v
estig
ation
V
i
:
V
i
sualization
M
:
M
ethodology
R
:
R
esources
Su
:
Su
pervision
So
:
So
ftw
are
D
:
D
ata
Curation
P
:
P
roject
Administration
V
a
:
V
a
lidation
O
:
Writing
-
O
riginal
Draft
Fu
:
Fu
nding
Acquisition
F
o
:
F
o
rmal
Analysis
E
:
Writing
-
Re
vie
w
&
E
diting
Int
J
Artif
Intell,
V
ol.
15,
No.
4,
August
2026:
3761–3769
Evaluation Warning : The document was created with Spire.PDF for Python.
Int
J
Artif
Intell
ISSN:
2252-8938
r
3767
CONFLICT
OF
INTEREST
ST
A
TEMENT
Authors
state
no
conflict
of
interest.
D
A
T
A
A
V
AILABILITY
The
data
that
support
the
findings
of
this
study
are
a
v
ailable
upon
reasonable
request
to
the
corresponding
author
,
[SEI].
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BIOGRAPHIES
OF
A
UTHORS
Pr
of
.
Dr
.
Sofyan
El
Idrissi
holds
a
doctor
of
Biotechnologies
and
Digital
Healthcare
de
gree
from
Abdelmalek
Essaadi
Uni
v
ersity
,
Morocco
in
2026.
He
is
professor
of
biology
at
AREF
Morocco,
a
researcher
in
oncology
,
a
t
the
C3S
Lab
Computer
Science
and
Smart
Systems
(C3S)
Laboratory
,
F
acul
ty
of
Sciences
and
T
echnologies
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
angier
,
Morocco.
Professor
at
“Institut
Genomic
Des
Sciences
De
La
Sante”
professional
training
institute
in
the
field
of
health
and
medical
sciences.
He
can
be
contacted
at
email:
idrissisofyan38@gmail.com.
Dr
.
Y
assine
Drider
is
Doctor
of
Pharmac
y
,
F
aculty
of
Medicine
and
Pharmac
y
Rabat,
Morocco.
He
is
founder
and
o
wner
of
pharmac
y
El
Y
ahiaouin.
He
is
supervising
professor
at
Institut
Genomic
Des
Sciences
De
La
Sante,
institute
of
professional
training
in
the
field
of
health
and
medical
sciences.
He
is
doctoral
researcher
in
oncology
,
at
the
Computer
Science
and
Smart
Systems
(C3S)
Laboratory
,
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
angier
,
Morocco.
He
is
an
author
of
the
book
entitled:
“La
biologie
quantique”.
He
can
be
contacted
at
email:
yassinedrider@gmail.com.
Int
J
Artif
Intell,
V
ol.
15,
No.
4,
August
2026:
3761–3769
Evaluation Warning : The document was created with Spire.PDF for Python.
Int
J
Artif
Intell
ISSN:
2252-8938
r
3769
Pr
of
.
Dr
.
Ikram
Ben
Abdel
Ouahab
is
an
assistant
professor
in
the
Department
of
Computer
Science
at
the
F
aculty
of
Sciences
and
T
echniques
of
T
angier
,
Morocco.
She
is
a
researcher
and
member
of
the
data
and
intelligent
systems
(DIS)
research
team,
at
the
Computer
Science
and
Smart
Systems
(C3S)
Laboratory
,
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
angier
,
Morocco.
She
recei
v
ed
her
Ph.D.
in
Cybersecurity
and
AI
from
Abdelmalek
Essaadi
Uni
v
ersity
.
She
has
partici
pated
in
numerous
international
conferences
and
has
published
se
v
eral
scientific
papers
in
collaboration
with
her
laboratory
colleagues.
Her
primary
research
interests
include
c
ybersecurity
,
mal
w
are
analysis,
AI,
AI
in
oncology
,
and
the
internet
of
things
(IoT).
She
can
be
contacted
at
email:
ibenabdelouahab@uae.ac.ma.
Pr
of
.
Dr
.
Mohammed
Bouhorma
is
a
full
professor
and
e
xperienced
academic
who
has
more
than
25
years
of
teaching
and
tutoring
e
xperience
in
the
areas
of
information
security
,
security
protocols,
AI,
big
data,
and
digital
forensics
at
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Abdelmalek
Essaadi
Uni
v
ersi
ty
,
T
etouan,
Morocco.
He
is
member
of
research
team
at
the
Computer
Science
and
Smart
Systems
(C3S)
Laboratory
,
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
angier
,
Morocco.
His
research
interes
ts
include
c
yber
-security
,
IoT
,
bigdata
analytics,
AI,
smart
cities
technology
,
and
serious
g
ames.
He
can
be
contacted
at
email:
mbouhorma@uae.ac.ma.
Pr
of
.
Dr
.
F
atiha
El
Ouaai
is
a
full
professor
at
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Abdelmalek
Essaadi
Uni
v
ersity
,
T
etouan,
Morocco.
Her
research
spans
bioinformatics,
human-computer
interaction,
computer
communications,
and
computer
security
.
She
is
member
of
research
team
a
t
the
Computer
Science
and
Smart
Systems
(C3S)
Labora
tory
,
F
aculty
of
Sciences
and
T
echnologies
of
T
angier
,
Uni
v
ersity
Abdelmalek
Essaadi,
T
angier
,
Morocco.
Her
e
xceptional
contrib
utions
and
publications
ha
v
e
earned
her
recognition,
and
she
acti
v
el
y
participates
in
academic
e
v
ents.
Her
research
adv
ances
scientific
kno
wledge
and
dri
v
es
inno
v
ation
in
multiple
disciplines.
She
can
be
contacted
at
email:
elouaaif@gmail.com.
Deep
learning
for
cate
gorizing
micr
osatellite
stability
in
color
ectal
cancer
(Sofyan
El
Idrissi)
Evaluation Warning : The document was created with Spire.PDF for Python.