CT影像组学联合临床病理特征模型预测非转移性2-3级肾透明细胞癌术后无病生存期的研究
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南京医科大学第一附属医院放射科

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国家自然科学基金项目(面上项目,重点项目,重大项目)


CT Radiomics Combined with Clinical-Pathological Features Predict Disease-Free Survival in Non-Metastatic Grades 2-3 Clear Cell Renal Cell Carcinoma
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    摘要:

    摘要:目的:对比术前增强CT影像组学特征模型与临床病理特征模型预测非转移性2-3级肾透明细胞癌(clear cell renal cell carcinoma ,ccRCC)患者术后无病生存期(disease-free survival ,DFS)的价值。方法:回顾性分析2013年1月-2020年12月行手术治疗且术后病理分级为2-3级的315例非转移性ccRCC患者,收集患者术前增强CT图像、临床病理资料以及DFS随访信息,勾画病灶感兴趣区并使用python提取组学特征,利用最小绝对收缩和选择算子以及COX回归分析计算患者影像组学评分,分别构建临床病理特征模型、影像组学模型(皮髓质期,实质期,皮髓质期+实质期)以及影像组学与临床病理特征联合模型预测患者DFS。结果:在预测非转移性2-3级ccRCC患者DFS时,皮髓质期+实质期组学模型预测效能(C-index:训练组0.848,验证组0.754)高于单一时期影像组学模型(皮髓质期C-index:训练组0.832,验证组0.701,实质期C-index:训练组0.842,验证组0.720)。而组学特征与临床病理特征构建的联合模型拥有最高的预测效能(C-index:训练组0.857,验证组0.832)。结论:基于术前增强CT皮髓质期+实质期图像提取的影像组学特征结合临床病理特征构建的模型有助于预测非转移性2-3级ccRCC患者术后DFS。

    Abstract:

    Abstract: Objective: To evaluate the predictive value of preoperative enhanced CT radiomic feature models in comparison with clinical-pathological feature models for disease-free survival (DFS) in patients with non-metastatic grades 2-3 clear cell renal cell carcinoma (ccRCC). Methods: A retrospective analysis was conducted on 315 patients with non-metastatic ccRCC who underwent surgical treatment and were pathologically graded as grades 2-3 between January 2013 and December 2020. Preoperative enhanced CT images, clinical-pathological information, and DFS data were collected. The region of interest (ROI) of the lesion was delineated using ITK-SNAP, and radiomic features were extracted using Python. Patients' radiomic scores were calculated using the least absolute shrinkage and selection operator (LASSO) and Cox regression analysis. Clinical-pathological feature models, radiomic models (corticomedullary phase, parenchymal phase, corticomedullary + parenchymal phase), and combined radiomic and clinical-pathological feature models were constructed to predict patients' DFS efficacy. Results: When predicting DFS in non-metastatic grades 2-3 ccRCC patients, the combined radiomic model of corticomedullary + parenchymal phase demonstrated superior predictive efficacy (C-index: training set 0.848, validation set 0.754) compared to single-phase radiomic models (corticomedullary phase C-index: training set 0.832, validation set 0.701; parenchymal phase C-index: training set 0.842, validation set 0.720). However, the combined model incorporating both radiomic and clinical-pathological features exhibited the highest predictive efficacy (C-index: training set 0.857, validation set 0.832). Conclusion: The model combining radiomic features extracted from preoperative enhanced CT images of corticomedullary and parenchymal phases with clinicopathological features assists in predicting postoperative DFS in non-metastatic grades 2-3 ccRCC.

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  • 收稿日期:2024-08-18
  • 最后修改日期:2024-10-12
  • 录用日期:2025-04-28
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