Yang C S, Chen W D, Gong G Z, Li Z J, Qiu Q T, Yin Y
Department of Oncology, Jining First People's Hospital, Jining 272000, China.
Department of Radiophysical Technology, Shandong Cancer Hospital, Jinan 250117, China.
Zhonghua Zhong Liu Za Zhi. 2019 Apr 23;41(4):282-287. doi: 10.3760/cma.j.issn.0253-3766.2019.04.007.
To explore the ability of computed-tomography (CT) radiomic features to predict the Epidermal growth factor receptor (EGFR) mutation status and the therapeutic response of advanced lung adenocarcinoma to EGFR- Tyrosine kinase inhibitors (TKIs) treatment. A retrospective analysis was performed on 253 patients diagnosed as advanced lung adenocarcinoma, who underwent EGFR mutation detection, and those with EGFR sensitive mutation were treated with TKIs. Using the Lasso regression model and the 10 fold cross-validation method, the radiomic features of predicted EGFR mutation status and the screening of TKIs for sensitive populations were obtained. 715 radiomic features were extracted from unenhanced, arterial phase and venous phase, respectively. The area under curve (AUC) values of the multi-phases including unenhanced, arterial phase and venous phase of the EGFR mutation status validation group were 0.763, 0.807 and 0.808, respectively. The number of radiomic features extracted from the multi-phases were 5, 18 and 23, respectively, which could distinguish the EGFR mutation status. The AUC values of the multi-phases of the EGFR-TKIs sensitive validation group were 0.730, 0.833 and 0.895, respectively. The number of radiomic features extracted from the multi-phases were 3, 7 and 22, respectively, which can be used to screen the superior population for TKIs treatment. The efficiency of radiomic features extracted from venous phase in predicting EGFR mutant status and EGFR-TKIs sensitivity was significantly superior than those of unenhanced and arterial phase. The radiomic features of CT scanning can be used as the radiomics biomarker to predict the EGFR mutation status of lung adenocarcinoma and to further screen the dominant population in TKIs therapy, which provides the basis for targeted therapy.
探讨计算机断层扫描(CT)影像组学特征预测晚期肺腺癌表皮生长因子受体(EGFR)突变状态及对EGFR酪氨酸激酶抑制剂(TKIs)治疗反应的能力。对253例诊断为晚期肺腺癌且接受EGFR突变检测的患者进行回顾性分析,其中EGFR敏感突变患者接受TKIs治疗。采用Lasso回归模型和10折交叉验证法,获得预测EGFR突变状态的影像组学特征及筛选TKIs敏感人群的特征。分别从未增强、动脉期和静脉期提取715个影像组学特征。EGFR突变状态验证组未增强、动脉期和静脉期多期的曲线下面积(AUC)值分别为0.763、0.807和0.808。多期提取的可区分EGFR突变状态的影像组学特征数量分别为5、18和23个。EGFR-TKIs敏感验证组多期的AUC值分别为0.730、0.833和0.895。多期提取的可用于筛选TKIs治疗优势人群的影像组学特征数量分别为3、7和22个。静脉期提取的影像组学特征预测EGFR突变状态和EGFR-TKIs敏感性的效率显著优于未增强期和动脉期。CT扫描的影像组学特征可作为影像组学生物标志物预测肺腺癌的EGFR突变状态并进一步筛选TKIs治疗的优势人群,为靶向治疗提供依据。