摘要
目的:基于超声影像组学特征和临床信息术前无创预测子宫内膜癌(endometrial carcinoma,EC)的微卫星不稳定性(microsatellite instability,MSI),为临床防治和个性化治疗提供参考依据。方法:回顾性收集2022年6月至2024年6月在天津医科大学肿瘤医院经手术病理确诊的60例EC患者的临床和超声资料,并将其分为MSI组(25例)和微卫星稳定(microsatellite stable,MSS)组(35例)。提取瘤内、瘤内+瘤周1 mm、瘤内+瘤周2 mm以及瘤内+瘤周3 mm感兴趣区(regions of interest,ROIs)超声图像的影像组学特征,分别构建影像组学模型,选取效能最高的影像组学模型并结合临床因素构建联合模型。通过受试者工作特征(receiver operating characteristic,ROC)曲线分析评估各模型的预测效能。结果MSI组与MSS组在患者年龄、子宫内膜厚度及个人既往恶性肿瘤病史方面均呈显著性差异(均P<0.05)。瘤内+瘤周2 mm影像组学模型在4种影像组学模型中效能最高,曲线下面积(area under the curve,AUC)为0.80。临床模型的AUC为0.88,联合模型的AUC高达0.97,联合模型在敏感度、特异性和准确性方面均优于单一模型(P<0.05)。结论:结合临床信息与瘤内+瘤周的超声影像组学特征构建的联合模型,在术前预测EC的MSI方面具有较高的临床价值,有益于为患者打造个性化的治疗路径。
Objective:Preoperative non-invasive prediction of microsatellite instability(MSI)in endometrial carcinoma(EC)based on ultrasound radiomic features and clinical information provides a reference for clinical prevention,treatment,and personalized therapy.Methods:The clinical and ultrasonographic data of 60 patients with EC confirmed by surgical pathology at the Tianjin Medical University Cancer Institute&Hospital from June 2022 to June 2024 were collected for retrospective analyses.The patients were assigned into MSI(25 patients)and microsatellite stable(MSS)(35 patients)groups.Radiomic features were extracted from ultrasound images in the following four distinct regions of interest(ROIs):intratumor region,intratumor+1 mm peritumoral region,intratumor+2 mm peritumoral region,and intratumor+3 mm peritumoral region.Radiomics models were constructed based on the features of each ROI.The radiomics model that demonstrated the highest predictive performance was selected and integrated with clinical factors to build a comprehensive model,and the predictive efficacy of each model was assessed using receiver operating characteristic(ROC)curve analysis.Results:Significant differences in patient age,endometrial thickness,and personal history of previous malignancies(all P<0.05)were observed between MSI and MSS groups.The intratumor+2 mm peritumoral radiomics model achieved the highest AUC(0.80)among the four radiomics models.The clinical model achieved an AUC of 0.88,whereas the comprehensive model achieved the highest AUC overall(0.97).The comprehensive model significantly outperformed both the clinical and best-performing radiomics models in sensitivity,specificity,and accuracy(P<0.05).Conclusions:Thecomprehensive model constructed by combining clinical information with ultrasound radiomics features of intratumor+peritumor imaging provides high clinical value in preoperatively predicting the MSI of EC,which can aid in creating a personalized treatment plan for each patient.
作者
张岱
杨凡
穆佳丽
王莹
侯文静
张坦
魏玺
Dai Zhang;Fan Yang;Jiali Mu;Ying Wang;Wenjing Hou;Tan Zhang;Xi Wei(Department of Ultrasound Diagnosis and Treatment,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)
出处
《中国肿瘤临床》
北大核心
2025年第20期1042-1052,共11页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金面上项目(编号:82272008)
天津市自然科学基金项目(编号:24JCZDJC00990)
国家重点研发计划项目(编号:2024YFA1802700)
天津市医学重点学科建设项目(编号:TJYXZDXK-3-015C)
四大慢病重大专项项目(编号:2024ZD0525600)
天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-009A)
天津医科大学肿瘤医院2022年博士启动基金项目(编号:B2217)资助。
关键词
子宫内膜癌
微卫星不稳定性
影像组学
临床预测
个性化治疗
endometrial carcinoma(EC)
microsatellite instability(MSI)
radiomics
clinical prediction
personalized therapy
