经导管动脉化疗栓塞加酪氨酸激酶抑制剂治疗肝细胞癌患者生存预测模型的开发与验证。

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiologia Medica Pub Date : 2024-11-01 Epub Date: 2024-10-14 DOI:10.1007/s11547-024-01890-z
Kun Huang, Haikuan Liu, Yanqin Wu, Wenzhe Fan, Yue Zhao, Miao Xue, Yiyang Tang, Shi-Ting Feng, Jiaping Li
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引用次数: 0

摘要

背景:由于分子生物学和微环境的异质性,接受经导管动脉化疗栓塞(TACE)和酪氨酸激酶抑制剂(TKIs)治疗的肝细胞癌(HCC)患者的疗效各不相同。我们研究了利用临床放射学特征、信号通路突变负荷和放射组学特征预测生存预后的组合模型:方法:由 111 名 HCC 患者组成的两个队列用于建立预后模型。训练队列和测试队列分别包括 78 人和 33 人。根据 17 种癌症相关信号通路计算突变负荷。使用放射组学系统从计算机断层扫描图像中提取和选择放射组学特征。根据临床放射学指标、突变负荷和放射组学评分(rad-score)建立了预测总生存期(OS)和无进展生存期(PFS)的模型:结果:东部合作肿瘤学组表现状态、Child-Pugh分级、瘤周增强、PI3K_AKT和缺氧突变负荷以及放射组学评分被用于创建预测OS的综合模型。C指数为0.805(训练队列)和0.768(测试队列)。1年、2年和3年OS的曲线下面积(AUC)分别为0.889、0.900和0.917。预测PFS时,使用了甲胎蛋白水平、肿瘤强化模式、缺氧和受体酪氨酸激酶突变负荷以及rad-score。C指数为0.782(训练队列)和0.766(测试队列)。6个月和12个月PFS的AUC分别为0.885和0.925。校准和决策曲线分析证实了模型的准确性和临床潜力:提名图模型有望预测接受TACE加TKIs治疗的中晚期HCC患者的OS和PFS,为治疗决策和监测患者进展提供了一种有前途的工具。
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Development and validation of survival prediction models for patients with hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus tyrosine kinase inhibitors.

Background: Due to heterogeneity of molecular biology and microenvironment, therapeutic efficacy varies among hepatocellular carcinoma (HCC) patients treated with transcatheter arterial chemoembolization (TACE) and tyrosine kinase inhibitors (TKIs). We examined combined models using clinicoradiological characteristics, mutational burden of signaling pathways, and radiomics features to predict survival prognosis.

Methods: Two cohorts comprising 111 patients with HCC were used to build prognostic models. The training and test cohorts included 78 and 33 individuals, respectively. Mutational burden was calculated based on 17 cancer-associated signaling pathways. Radiomic features were extracted and selected from computed tomography images using a pyradiomics system. Models based on clinicoradiological indicators, mutational burden, and radiomics score (rad-score) were built to predict overall survival (OS) and progression-free survival (PFS).

Results: Eastern Cooperative Oncology Group performance status, Child-Pugh class, peritumoral enhancement, PI3K_AKT and hypoxia mutational burden, and rad-score were used to create a combined model predicting OS. C-indices were 0.805 (training cohort) and 0.768 (test cohort). The areas under the curve (AUCs) were 0.889, 0.900, and 0.917 for 1-year, 2-year, and 3-year OS, respectively. To predict PFS, alpha-fetoprotein level, tumor enhancement pattern, hypoxia and receptor tyrosine kinase mutational burden, and rad-score were used. C-indices were 0.782 (training cohort) and 0.766 (test cohort). AUCs were 0.885 and 0.925 for 6-month and 12-month PFS, respectively. Calibration and decision curve analyses supported the model's accuracy and clinical potential.

Conclusions: The nomogram models are hopeful to predict OS and PFS in patients with intermediate-advanced HCC treated with TACE plus TKIs, offering a promising tool for treatment decisions and monitoring patient progress.

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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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