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南京医科大学学报(自然科学版) 第44卷第1期
· 52 · Journal of Nanjing Medical University(Natural Sciences) 2024年1月
·临床研究·
影像组学联合临床病理特征预测早期宫颈癌无病生存期的效能
宋佳成,蒋晓婷,张爱宁,张 晶,陈 婷 *
南京医科大学第一附属医院放射科,江苏 南京 210029
[摘 要] 目的:对比最优磁共振组学参数及临床病理参数预测早期宫颈癌患者无病生存期的诊断效能。方法:回顾性分
析 2013 年 1 月—2018 年 6 月行根治性子宫切除及淋巴结清扫术的 186 例早期宫颈癌患者[术前国际妇产科联盟(Federation
International of Gynecology and Obstetrics,FIGO)分期ⅠB~ⅡA],搜集患者多模态磁共振组学参数、临床特征、术后病理特征及
患者术后无病生存期,用最小决策收缩和选择算子(LASSO)及比例风险回归模型来计算影像组学评分(Rad⁃score),构建临床
病理特征模型(包括有意义的临床特征和病理特征)、影像组学模型(T1CE、DWI、T2WI、T1CE+DWI、T1CE+T2WI、DWI+T2WI
和T1CE+DWI+T2WI的影像组学评分)及联合模型对早期宫颈癌患者无病生存期的预测效能进行相互比较。结果:在预测早
期宫颈癌无病生存期中,T1CE序列的组学模型(C指数:训练集0.798,验证集0.758)优于临床病理模型(C指数:训练集0.746,
验证集0.641)。联合模型(病理类型、淋巴结转移及T1CE的影像组学评分)拥有最高的诊断效能(C指数:训练集0.848,验证集
0.784)。结论:基于T1CE的影像组学评分联合临床病理特征对早期宫颈癌无病生存期具有较高的预测效能。
[关键词] 宫颈癌;无病生存期;影像组学;核磁共振成像
[中图分类号] R737.33 [文献标志码] A [文章编号] 1007⁃4368(2024)01⁃052⁃08
doi:10.7655/NYDXBNSN220980
Value of optimal MRI radiomics parameters and clinicopathological factors in predicting
disease⁃free survival of early⁃stage cervical cancer patients
SONG Jiacheng,JIANG Xiaoting,ZHANG Aining,ZHANG Jing,CHEN Ting *
Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
[Abstract] Objective:To determine the optimal preoperative magnetic resonance imaging(MRI)radiomics parameters and compare
the values in predicting disease⁃free survival(DFS)of early⁃stage cervical cancer patients with clinicopathological factors. Methods:A
total of 186 patients with early⁃stage cervical cancers(preoperative FIGO stage ⅠB-ⅡA),who underwent radical hysterectomy with
lymphadenectomy during January 2013 and June 2018,were retrospectively reviewed. Multi⁃sequence MR data,clinicopathologic data,
and DFS data were collected;least⁃absolute shrinkage and selection operator(LASSO)and the Cox proportional hazard regression
model were applied to construct a Rad ⁃ score. Clinicopathological models(with significant clinicopathological features),radiomics
models(Rad⁃scores for T1CE,DWI,T2WI,T1CE+DWI,T1CE+T2WI,DWI+T2WI,and T1CE+DWI+T2WI),and combined models
(the Rad ⁃ score model combined with significant clinicopathological features)were compared using a multivariable Cox model.
Results:The T1CE radiomics model was the most stable and optimal model(C⁃index for training,0.798;for validation,0.758)of all the
radiomics models. The radiomics model of T1CE showed higher prognostic performance than the clinicopathological model(C⁃index for
training,0.746;for validation,0.641). The combined model(histological type of adenocarcinoma,lymph⁃node metastasis together with
Rad⁃score for T1CE)showed the highest prognostic performance in estimating DFS(C⁃index for training,0.848;for validation,0.784).
Conclusion:An MRI⁃derived Rad⁃score of T1CE combined with a clinicopathological model is optimal in predicting DFS in early⁃stage
cervical cancers.
[Key words] cervical cancer;disease⁃free survival;radiomics;magnetic resonance imaging
[J Nanjing Med Univ,2024,44(01):052⁃059]
[基金项目] 南京医科大学第一附属医院国家自然科学基金青年基金培育计划(PY2021002)
∗
通信作者(Corresponding author),E⁃mail:Chentingwzc@163.com