胶质瘤是中枢神经系统高致死性恶性肿瘤,传统治疗手段效果有限。近年来,异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)突变作为关键分子标志物,不仅重塑了胶质瘤分子分型体系,更成为靶向治疗的重要突破口。2016年及2021年世界卫生组织(...胶质瘤是中枢神经系统高致死性恶性肿瘤,传统治疗手段效果有限。近年来,异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)突变作为关键分子标志物,不仅重塑了胶质瘤分子分型体系,更成为靶向治疗的重要突破口。2016年及2021年世界卫生组织(World Health Organization,WHO)指南将IDH突变纳入胶质瘤分类标准,将其分为IDH突变型星形细胞瘤、少突胶质细胞瘤(伴1p/19q共缺失)及IDH野生型胶质母细胞瘤。IDH突变通过代谢产物D-2-羟基戊二酸(D-2-hydroxyglutarate,D-2-HG)累积,驱动表观遗传异常及肿瘤进展。针对IDH突变的靶向治疗取得突破性进展:III期INDIGO试验证实,Vorasidenib(IDH1/2双重抑制剂)可显著延长2级IDH突变胶质瘤患者的无进展生存期,并延迟二次干预时间;艾伏尼布(Ivosidenib)等IDH1抑制剂在复发胶质瘤中亦展现抗肿瘤活性。此外,Olutasidenib、DS-1001等新型脑渗透抑制剂临床试验结果乐观。尽管放化疗仍是标准治疗,IDH抑制剂因其低毒性和精准性被纳入指南推荐,但联合治疗策略及耐药机制仍需进一步探索。未来,基于IDH突变的分子分型与靶向治疗的多模态整合,有望为胶质瘤患者提供更优生存获益。展开更多
Accurate genotyping and prognosis of glioma patients present significant clinical challenges,often dependent on subjective judgement and insufficient scientific evidence.This study aims to develop a robust,noninvasive...Accurate genotyping and prognosis of glioma patients present significant clinical challenges,often dependent on subjective judgement and insufficient scientific evidence.This study aims to develop a robust,noninvasive preoperative multi-modal MRIbased transformer learning model to predict IDH genotyping and glioma prognosis.This multi-centre study included 563 glioma patients to develop an interpretable classification model utilising various preoperative imaging sequences,including T1-weighted,T2-weighted,fluid-attenuated inversion recovery,contrast-enhanced T1-weighted,and diffusion-weighted imaging.The model employs a multi-task learning framework to extract and fuse radiomic,deep learning,and clinical features for IDH genotyping and glioma prognosis.Additionally,a multi-modal transformer strategy is integrated to analyse structural and functional MRI,thereby enhancing model performance.Experimental results indicate that the model demonstrates superior performance,surpassing previous research and other state-of-the-art methods.The model achieves an AUC of 91.40% in the IDH genotyping task and 93.37% in the glioma prognosis task.Group analysis reveals that the model exhibits higher sensitivity to IDH-mutant cases and more accurately identifies low-risk groups compared to medium-or high-risk groups.This study aims to achieve accurate IDH genotyping and glioma prognosis through effective classification method,offering valuable diagnostic insights for clinical practice and expediting treatment decisions.展开更多
Cervical cancer is a major malignancy that poses a significant threat to women's health[1].In 2020,an estimated 604,000 new cases and 342,000 deaths were reported globally[2].The most common pathological subtype i...Cervical cancer is a major malignancy that poses a significant threat to women's health[1].In 2020,an estimated 604,000 new cases and 342,000 deaths were reported globally[2].The most common pathological subtype is squamous cell carcinoma[3,4].However,treatment options for advanced cervical squamous cell carcinoma(CSCC)are limited.Surgery is often not feasible at this stage,resulting in poor prognosis[5,6].Therefore,identifying novel molecular markers and elucidating the mechanisms that drive CSCC growth and metastasis are crucial for improving treatment outcomes.展开更多
Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to huma...Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).展开更多
文摘胶质瘤是中枢神经系统高致死性恶性肿瘤,传统治疗手段效果有限。近年来,异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)突变作为关键分子标志物,不仅重塑了胶质瘤分子分型体系,更成为靶向治疗的重要突破口。2016年及2021年世界卫生组织(World Health Organization,WHO)指南将IDH突变纳入胶质瘤分类标准,将其分为IDH突变型星形细胞瘤、少突胶质细胞瘤(伴1p/19q共缺失)及IDH野生型胶质母细胞瘤。IDH突变通过代谢产物D-2-羟基戊二酸(D-2-hydroxyglutarate,D-2-HG)累积,驱动表观遗传异常及肿瘤进展。针对IDH突变的靶向治疗取得突破性进展:III期INDIGO试验证实,Vorasidenib(IDH1/2双重抑制剂)可显著延长2级IDH突变胶质瘤患者的无进展生存期,并延迟二次干预时间;艾伏尼布(Ivosidenib)等IDH1抑制剂在复发胶质瘤中亦展现抗肿瘤活性。此外,Olutasidenib、DS-1001等新型脑渗透抑制剂临床试验结果乐观。尽管放化疗仍是标准治疗,IDH抑制剂因其低毒性和精准性被纳入指南推荐,但联合治疗策略及耐药机制仍需进一步探索。未来,基于IDH突变的分子分型与靶向治疗的多模态整合,有望为胶质瘤患者提供更优生存获益。
基金supported by the National Natural Science Foundation of China(Grants 82441022,82371934)Medical Science and Technology Research Project of Henan Province(SBGJ202101002)+1 种基金Joint Fund of Henan Province Science and Technology R&D Programme(225200810062)Henan Provincial Medical Science and Technology Research Joint Construction Project(LHGJ20240053,LHGJ20240036).
文摘Accurate genotyping and prognosis of glioma patients present significant clinical challenges,often dependent on subjective judgement and insufficient scientific evidence.This study aims to develop a robust,noninvasive preoperative multi-modal MRIbased transformer learning model to predict IDH genotyping and glioma prognosis.This multi-centre study included 563 glioma patients to develop an interpretable classification model utilising various preoperative imaging sequences,including T1-weighted,T2-weighted,fluid-attenuated inversion recovery,contrast-enhanced T1-weighted,and diffusion-weighted imaging.The model employs a multi-task learning framework to extract and fuse radiomic,deep learning,and clinical features for IDH genotyping and glioma prognosis.Additionally,a multi-modal transformer strategy is integrated to analyse structural and functional MRI,thereby enhancing model performance.Experimental results indicate that the model demonstrates superior performance,surpassing previous research and other state-of-the-art methods.The model achieves an AUC of 91.40% in the IDH genotyping task and 93.37% in the glioma prognosis task.Group analysis reveals that the model exhibits higher sensitivity to IDH-mutant cases and more accurately identifies low-risk groups compared to medium-or high-risk groups.This study aims to achieve accurate IDH genotyping and glioma prognosis through effective classification method,offering valuable diagnostic insights for clinical practice and expediting treatment decisions.
基金supported by the Hebei Provincial Central Guidance Local Science and Technology Development Fund(grant number 236Z7714G).
文摘Cervical cancer is a major malignancy that poses a significant threat to women's health[1].In 2020,an estimated 604,000 new cases and 342,000 deaths were reported globally[2].The most common pathological subtype is squamous cell carcinoma[3,4].However,treatment options for advanced cervical squamous cell carcinoma(CSCC)are limited.Surgery is often not feasible at this stage,resulting in poor prognosis[5,6].Therefore,identifying novel molecular markers and elucidating the mechanisms that drive CSCC growth and metastasis are crucial for improving treatment outcomes.
基金supported by a project funded by the Hebei Provincial Central Guidance Local Science and Technology Development Fund(236Z7714G)。
文摘Cervical cancer,a leading malignancy globally,poses a significant threat to women's health,with an estimated 604,000 new cases and 342,000 deaths reported in 2020^([1]).As cervical cancer is closely linked to human papilloma virus(HPV)infection,early detection relies on HPV screening;however,late-stage prognosis remains poor,underscoring the need for novel diagnostic and therapeutic targets^([2]).
