Pathological diagnosis.

Endometrial cancer screening is crucial for clinical treatment. Currently, cytopathologists analyze cytopathology images is considered a popular screening method, but manual diagnosis is time-consuming and laborious. Deep learning can provide objective guidance efficiency. But endometrial cytopathology images often come from different medical centers with different staining styles. It decreases the generalization ability of deep learning models in cytopathology images analysis, leading to poor performance. This study presents a robust automated screening framework for endometrial cancer that can be applied to cytopathology images with different staining styles, and provide an objective diagnostic reference for cytopathologists, thus contributing to clinical treatment. We collected and built the XJTU-EC dataset, the first cytopathology dataset that includes segmentation and classification labels. And we propose an efficient two-stage framework for adapting different staining style images, and screening endometrial cancer at the cellular level. Specifically, in the first stage, a novel CM-UNet is utilized to segment cell clumps, with a channel attention (CA) module and a multi-level semantic supervision (MSS) module. It can ignore staining variance and focus on extracting semantic information for segmentation. In the second stage, we propose a robust and effective classification algorithm based on contrastive learning, ECRNet. By momentum-based updating and adding labeled memory banks, it can reduce most of the false negative results. On the XJTU-EC dataset, CM-UNet achieves an excellent segmentation performance, and ECRNet obtains an accuracy of 98.50%, a precision of 99.32% and a sensitivity of 97.67% on the test set, which outperforms other competitive classical models. Our method robustly predicts endometrial cancer on cytopathologic images with different staining styles, which will further advance research in endometrial cancer screening and provide early diagnosis for patients. The code will be available on GitHub.