MAPLE: Multi-scale Attribute-enhanced Prompt Learning for Few-shot Whole Slide Image Classification

Prompt learning has emerged as a promising paradigm for adapting pre-trained vision-language models (VLMs) to few-shot whole slide image (WSI) classification by aligning visual features with textual representations, thereby reducing annotation cost and enhancing model generalization. Nevertheless, existing methods typically rely on slide-level prompts and fail to capture the subtype-specific phenotypic variations of histological entities (e.g., nuclei, glands) that are critical for cancer diagnosis. To address this gap, we propose Multi-scale Attribute-enhanced Prompt Learning (MAPLE), a hierarchical framework for few-shot WSI classification that jointly integrates multi-scale visual semantics and performs prediction at both the entity and slide levels. Specifically, we first leverage large language models (LLMs) to generate entity-level prompts that can help identify multi-scale histological entities and their phenotypic attributes, as well as slide-level prompts to capture global visual descriptions. Then, an entity-guided cross-attention module is proposed to generate entity-level features, followed by aligning with their corresponding subtype-specific attributes for fine-grained entity-level prediction. To enrich entity representations, we further develop a cross-scale entity graph learning module that can update these representations by capturing their semantic correlations within and across scales. The refined representations are then aggregated into a slide-level representation and aligned with the corresponding prompts for slide-level prediction. Finally, we combine both entity-level and slide-level outputs to produce the final prediction results. Results on three cancer cohorts confirm the effectiveness of our approach in addressing few-shot pathology diagnosis tasks.