A pilot study of volume measurement as a method of tumor response evaluation to aid biomarker development.
A pilot study of volume measurement as a method of tumor response evaluation to aid biomarker development.
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DOI：
10.1158/1078-0432.ccr-10-0125
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发表时间：
2010-09-15
期刊：
影响因子：
--
通讯作者：
Schwartz LH
中科院分区：
文献类型：
--
作者：
Zhao B;Oxnard GR;Moskowitz CS;Kris MG;Pao W;Guo P;Rusch VM;Ladanyi M;Rizvi NA;Schwartz LH
组织生物标志物的发现可能受到传统肿瘤测量技术的限制，这些技术准确区分敏感性和耐药性肿瘤的能力不确定。CT成像的半自动体积测量有可能更准确地捕获肿瘤生长动态，从而更准确地分离敏感和耐药肿瘤，并更准确地比较组织特征。对48例早期非小细胞肺癌（NSCLC）患者进行吉非替尼敏感性的临床研究。在基线和吉非替尼治疗3周后进行高分辨率计算机断层扫描。然后切除肿瘤并进行分子分析。使用半自动算法进行一维和体积测量。评估测量变化区分有和无致敏突变的肿瘤的能力。44%的肿瘤有EGFR致敏突变。ROC曲线分析表明，体积测量比一维测量具有更高的曲线下面积，用于识别携带致敏突变的肿瘤（p = 0.009）。肿瘤体积减少>24.9%是最能区分有无致敏突变的肿瘤的成像标准（敏感性90%，特异性89%）。体积肿瘤测量在基于存在或不存在致敏突变来区分肿瘤方面优于一维肿瘤测量。使用基于体积的反应评估来开发组织生物标志物可以减少敏感和耐药肿瘤群体之间的污染，提高我们识别有意义的敏感性预测因子的能力。
Tissue biomarker discovery is potentially limited by conventional tumor measurement techniques, which have an uncertain ability to accurately distinguish sensitive and resistant tumors. Semi-automated volumetric measurement of CT imaging has the potential to more accurately capture tumor growth dynamics, allowing for more exact separation of sensitive and resistant tumors and a more accurate comparison of tissue characteristics. 48 patients with early stage non-small cell lung cancer (NSCLC) and clinical characteristics of sensitivity to gefitinib were studied. High resolution computed tomography was performed at baseline and after 3 weeks of gefitinib. Tumors were then resected and molecularly profiled. Unidimensional and volumetric measurements were performed using a semi-automated algorithm. Measurement changes were evaluated for their ability to differentiate tumors with and without sensitizing mutations. 44% of tumors had EGFR sensitizing mutations. ROC curve analysis demonstrated that volumetric measurement had a higher area-under-the-curve than unidimensional measurement for identifying tumors harboring sensitizing mutations (p = 0.009). Tumor volume decrease of >24.9% was the imaging criteria best able to classify tumors with and without sensitizing mutations (sensitivity 90%, specificity 89%). Volumetric tumor measurement was better than unidimensional tumor measurement at distinguishing tumors based on presence or absence of a sensitizing mutation. Use of volume-based response assessment for development of tissue biomarkers could reduce contamination between sensitive and resistant tumor populations, improving our ability to identify meaningful predictors of sensitivity.