Prognostic and predictive value of radiomic signature in stage I lung adenocarcinomas following complete lobectomy.
Prognostic and predictive value of radiomic signature in stage I lung adenocarcinomas following complete lobectomy.
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全肺叶切除术后 I 期肺腺癌放射组学特征的预后和预测价值
DOI：
10.1186/s12967-022-03547-9
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发表时间：
2022-07-28
影响因子：
7.4
通讯作者：
Yu, Hong
中科院分区：
文献类型：
--
作者：
Nie, Wei;Tao, Guangyu;Lu, Zhenghai;Qian, Jie;Ge, Yaqiong;Wang, Shuyuan;Zhang, Xueyan;Zhong, Hua;Yu, Hong
I期可手术肺癌的总生存率（OS）相对较低，并非所有患者都能从辅助化疗中获益。本研究旨在开发和验证用于预测I期肺腺癌OS和辅助化疗候选者的放射组学特征（RS）。来自2个中心的共计474例患者被分为1个培训（n = 287）、1个内部验证（n = 122）和1个外部验证（n = 65）队列。我们从术前CT图像中提取了1218个放射组学特征，并构建了RS。我们进一步研究了RS在生存分析中的预后价值。评估治疗和RS之间的相互作用，以评估其预测价值。进行倾向评分匹配（PSM）。总体而言，确定了474例符合条件的I期肺腺癌患者（214例男性[45.1%];中位年龄60岁）。在训练和两个验证队列中，RS与OS显著相关（风险比[HR] > = 3.22）。在多变量分析中，RS仍然是调整临床病理变量的独立预后因素（校正HR> = 2.63）。在PSM分析中也证实了RS的预后价值。在I期患者中，RS状态和辅助化疗之间的相互作用是显著的（相互作用P = 0.020）。在分层分析中，仅在IB期疾病患者中观察到良好的化疗疗效（相互作用P < 0.001）。我们的研究结果表明，放射组学特征与I期肺腺癌患者的总生存率相关，并可能预测辅助化疗的获益，特别是在IB期患者中。放射组学特征作为无创性预测因子的潜力需要在未来的研究中得到证实。在线版本包含补充材料，可通过10.1186/s12967-022-03547-9获得。
The overall survival (OS) of stage I operable lung cancer is relatively low, and not all patients can benefit from adjuvant chemotherapy. This study aimed to develop and validate a radiomic signature (RS) for prediction of OS and adjuvant chemotherapy candidates in stage I lung adenocarcinoma. A total of 474 patients from 2 centers were divided into 1 training (n = 287), 1 internal validation (n = 122), and 1 external validation (n = 65) cohorts. We extracted 1218 radiomic features from preoperative CT images and constructed RS. We further investigated the prognostic value of the RS in survival analysis. Interaction between treatment and RS was assessed to evaluate its predictive value. Propensity score matching (PSM) was conducted. Overall, 474 eligible patients with stage I lung adenocarcinoma (214 men [45.1%]; median age, 60 years) were identified. The RS was significantly associated with OS in the training and two validation cohorts (hazard ratios [HRs] > = 3.22). In multivariable analysis, the RS remained an independent prognostic factor adjusting for clinicopathologic variables (adjusted HRs > = 2.63). The prognostic value of RS was also confirmed in PSM analysis. In stage I patients, the interaction between RS status and adjuvant chemotherapy was significant (interaction P = 0.020). Within the stratified analysis, good chemotherapy efficacy was only observed for patients with stage IB disease (interaction P < 0.001). Our results suggested that the radiomic signature was associated with overall survival in patients with stage I lung adenocarcinoma and might predict adjuvant chemotherapy benefit, especially in stage IB patients. The potential of radiomic signature as a noninvasive predictor needed to be confirmed in future studies. The online version contains supplementary material available at 10.1186/s12967-022-03547-9.
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