| 潘犇,梁长华,吴青霞,杨鑫淼,王慧慧,危涵羽.瘤内及瘤周CT影像组学评估结直肠腺癌患者KRAS基因状态[J].中国介入影像与治疗学,2024,21(11):685-689 |
| 瘤内及瘤周CT影像组学评估结直肠腺癌患者KRAS基因状态 |
| Intratumoral and peritumoral CT radiomics for evaluating KRAS gene status in patients with colorectal adenocarcinoma |
| 投稿时间：2024-09-11 修订日期：2024-10-14 |
| DOI：10.13929/j.issn.1672-8475.2024.11.008 |
| 中文关键词: 结直肠肿瘤 基因 体层摄影术，X线计算机 影像组学 |
| 英文关键词:colorectal neoplasms genes tomography,X-ray computed radiomics |
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| 中文摘要: |
| 目的 观察瘤内及瘤周CT影像组学评估结直肠腺癌患者KRAS基因状态的价值。方法 回顾性纳入245例结直肠腺癌患者，根据KRAS基因状态分为突变组（n=139）及野生组（n=106），并按7∶3比例分为训练集（n=171）与测试集（n=74）。比较组间临床资料，基于logistic回归分析筛选临床因素以建立临床模型；基于增强静脉期CT勾画瘤内感兴趣体积（VOI）、瘤周VOI及瘤内+瘤周VOI，提取影像组学特征并构建影像组学模型；以效能最佳的影像组学模型联合临床因素构建联合模型。分析各模型评估结直肠腺癌患者KRAS基因状态的价值。结果 突变组与野生组患者性别及癌胚抗原（CEA）差异均有统计学意义（P均＜0.05），二者均为结直肠腺癌患者KRAS基因状态的独立影响因素（P均＜0.05）。临床模型评估训练集及测试集结直肠腺癌患者KRAS基因状态的曲线下面积（AUC）分别为0.633及0.658。瘤内+瘤周3 mm模型为最佳影像组学模型，其在训练集及测试集的AUC分别为0.921及0.894；联合模型在训练集及测试集的AUC分别为0.949及0.956。在训练集，临床模型与瘤内+瘤周3 mm影像组学模型、临床模型与联合模型AUC差异均有统计学意义（P均＜0.001）；在测试集，上述模型两两比较差异均有统计学意义（P均＜0.05）。结论 基于增强静脉期CT瘤内+瘤周3 mm影像组学有助于评估结直肠腺癌患者KRAS基因状态；联合患者性别及CEA可进一步提高诊断效能。 |
| 英文摘要: |
| Objective To observe the value of intratumoral and peritumoral CT radiomics for evaluating KRAS gene status in patients with colorectal adenocarcinoma. Methods Totally 245 patients with colorectal adenocarcinoma were retrospectively enrolled and divided into mutant group （n=139） and wild group （n=106） according to KRAS gene status， also divided into training set （n=171） and test set （n=74） at a ratio of 7∶3. Clinical data were compared between groups， and clinical factors were screened with logistic regression analysis to establish a clinical model. Based on enhanced venous phase CT images， intratumoral volume of interest （VOI）， peritumoral VOI， and intratumoral+peritumoral VOI were delineated， radiomics features were extracted， and radiomics models were constructed. The combination model was constructed based on the best radiomics model combined with clinical factors. The value of each model for evaluating KRAS gene status in patients with colorectal adenocarcinoma was analyzed. Results Significant differences of patients’ gender and carcinoembryonic antigen （CEA） were found between mutant group and wild group （both P＜0.05）， which were independent impact factors of KRAS gene status in patients with colorectal adenocarcinoma （both P＜0.05）. The area under the curve （AUC） of clinical model for evaluating KRAS gene status in patients with colorectal adenocarcinoma in training set and test set was 0.633 and 0.658， respectively. Intratumoral+peritumoral 3 mm model was the best radiomics model， with AUC of 0.921 and 0.894 in training set and test set， respectively. AUC of the combination model in training set and test set was 0.949 and 0.956， respectively. In training set， significant differences of AUC were found between clinical model and intratumoral+peritumoral 3 mm model， also between clinical model and combination model （both P＜0.001）， while in test set， significant differences of AUC were found between each two models （all P＜0.05）. Conclusion Intratumoral+peritumoral 3 mm radiomics based on enhanced venous phase CT could help to evaluate KRAS gene status in patients with colorectal adenocarcinoma. Combining with patients’ gender and CEA could further improve efficacy of this model. |
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