基于多参数磁共振的影像组学特征一致性聚类与早期宫颈癌临床及组织病理学特征相关性研究
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1.南京医科大学第一附属医院放射科;2.联影医疗中央研究院;3.西门子医疗磁共振研究合作中心;4.南京医科大学第一附属医院妇科

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    摘要:

    目的:探讨早期宫颈癌患者的MRI影像表型与各种临床及组织病理学特征之间的相关性。方法:回顾性收集2019年7月至2023年12月期间164例早期宫颈癌患者的磁共振影像组学特征和临床及组织病理学特征。将所有患者的肿瘤和盆腔淋巴结通过基于影像组学特征的一致性聚类分为两簇。比较两簇患者的临床及组织病理学特征的差异。结果:基于肿瘤的聚类分析显示两簇在平均年龄、组织学类型、肿瘤分化程度、淋巴血管间隙侵犯以及宫旁浸润上均没有统计学差异。与簇1相比,簇2患者的术后FIGO分期更晚 [IIA期及以上:56/92 (60.9%) vs. 22/72 (30.6%),P=0.001]、淋巴结转移的概率更大 [30/92 (32.6%) vs. 9/72 (12.5%),P=0. 002]、肿瘤更大(短径:28.38 ± 9.73 mm vs. 16.67 ± 6.32 mm,长径:34.34 ± 9.72 mm vs. 21.02 ± 7.39 mm,高度:29.92 ± 10.61 mm vs. 18.93 ± 8.01 mm,P均<0.001)且具有更深的间质浸润深度 [>2/3:62/92 (67.4%) vs. 26/72 (36.1%),P<0.001]。基于淋巴结的聚类分析显示两簇在短径、长径、短长比、信号、边缘和淋巴结转移中没有统计学差异。结论:基于肿瘤的多参数磁共振影像组学一致性聚类分析有助于识别早期宫颈癌患者影像组学特征与临床及组织病理学特征的关联,从而为术前危险分层提供了依据。

    Abstract:

    Objective: To investigate the correlation between imaging phenotypes of cervical cancer (CC) and various clinical and histopathological characteristics. Methods: The MRI radiomics features, along with clinical and histopathological characteristics of 164 patients with CC were collected retrospectively from July 2019 to December 2023. All patients were divided into two clusters by consensus clustering based on the radiomics features. The clinical and histopathological characteristics were compared between groups. Results: Clustering analysis based on tumors showed that compared with cluster 1, cluster 2 was associated with a higher correlation with advanced postoperative FIGO stage [IIA or later: 56/92 (60.9%) vs. 22/72 (30.6%), P=0.001], lymph node metastasis [30/92 (32.6%) vs. 9/72 (12.5%), P=0.002], larger tumor diameter in three dimensions (short diameter: 28.38 ± 9.73 mm vs. 16.67 ± 6.32 mm, long diameter: 34.34 ± 9.72 mm vs. 21.02 ± 7.39 mm, height: 29.92 ± 10.61 mm vs. 18.93 ± 8.01 mm, all P<0.001) and deeper stromal invasion [>2/3: 62/92 (67.4%) vs. 26/72 (36.1%), P<0.001]. Clustering analysis based on lymph nodes showed that difference between two clusters in short axis, long axis, short-to-long axis ratio, border, signal and metastasis was not statistically significant. Conclusion: Associations between radiomics features and clinical and histopathological characteristics of patients with CC could be identified by consensus clustering based on multiparametric MRI-based radiomics, suggesting possibilities for preoperative risk stratification.

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  • 收稿日期:2024-05-22
  • 最后修改日期:2024-06-25
  • 录用日期:2025-01-16
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