Label-Free Assessment of the Drug Resistance of Epithelial Ovarian Cancer Cells in a Microfluidic Holographic Flow Cytometer Boosted through Machine Learning

[Image: see text] About 75% of epithelial ovarian cancer (EOC) patients suffer from relapsing and develop drug resistance after primary chemotherapy. The commonly used clinical examinations and biological tumor tissue models for chemotherapeutic sensitivity are time-consuming and expensive. Research studies showed that the cell morphology-based method is promising to be a new route for chemotherapeutic sensitivity evaluation. Here, we offer how the drug resistance of EOC cells can be assessed through a label-free and high-throughput microfluidic flow cytometer equipped with a digital holographic microscope reinforced by machine learning. It is the first time that such type of assessment is performed to the best of our knowledge. Several morphologic and texture features at a single-cell level have been extracted from the quantitative phase images. In addition, we compared four common machine learning algorithms, including naive Bayes, decision tree, K-nearest neighbors, support vector machine (SVM), and fully connected network. The result shows that the SVM classifier achieves the optimal performance with an accuracy of 92.2% and an area under the curve of 0.96. This study demonstrates that the proposed method achieves high-accuracy, high-throughput, and label-free assessment of the drug resistance of EOC cells. Furthermore, it reflects strong potentialities to develop data-driven individualized chemotherapy treatments in the future.