Department of Radiology, Changhai Hospital, Navy Medical University, Shanghai, 200434, China.
Department of Pathology, Changhai Hospital, Navy Medical University, Shanghai, China.
Abdom Radiol (NY). 2021 Oct;46(10):4800-4816. doi: 10.1007/s00261-021-03159-9. Epub 2021 Jun 29.
To develop and validate a machine learning classifier based on magnetic resonance imaging (MRI), for the preoperative prediction of tumor-infiltrating lymphocytes (TILs) in patients with pancreatic ductal adenocarcinoma (PDAC).
In this retrospective study, 156 patients with PDAC underwent MR scan and surgical resection. The expression of CD4, CD8 and CD20 was detected and quantified using immunohistochemistry, and TILs score was achieved by Cox regression model. All patients were divided into TILs score-low and TILs score-high groups. The least absolute shrinkage and selection operator method and the extreme gradient boosting (XGBoost) were used to select the features and to construct a prediction model. The performance of the models was assessed using the training cohort (116 patients) and the validation cohort (40 patients), and decision curve analysis (DCA) was applied for clinical use.
The XGBoost prediction model showed good discrimination in the training (AUC 0.86; 95% CI 0.79-0.93) and validation sets (AUC 0.79; 95% CI 0.64-0.93). The sensitivity, specificity, and accuracy for the training set were 86.67%, 75.00%, and 0.81, respectively, whereas those for the validation set were 84.21%, 66.67%, and 0.75, respectively. Decision curve analysis indicated the clinical usefulness of the XGBoost classifier.
The model constructed by XGBoost could predict PDAC TILs and may aid clinical decision making for immune therapy.
开发并验证一种基于磁共振成像(MRI)的机器学习分类器,用于预测胰腺导管腺癌(PDAC)患者肿瘤浸润淋巴细胞(TILs)。
在这项回顾性研究中,156 例 PDAC 患者接受了 MRI 扫描和手术切除。使用免疫组织化学检测和量化 CD4、CD8 和 CD20 的表达,并通过 Cox 回归模型获得 TILs 评分。所有患者均分为 TILs 评分低和 TILs 评分高两组。采用最小绝对值收缩和选择算子方法和极端梯度增强(XGBoost)来选择特征并构建预测模型。使用训练队列(116 例患者)和验证队列(40 例患者)评估模型的性能,并应用决策曲线分析(DCA)进行临床应用。
XGBoost 预测模型在训练集(AUC 0.86;95%CI 0.79-0.93)和验证集(AUC 0.79;95%CI 0.64-0.93)中均表现出良好的区分度。训练集的敏感性、特异性和准确性分别为 86.67%、75.00%和 0.81,验证集的敏感性、特异性和准确性分别为 84.21%、66.67%和 0.75。决策曲线分析表明 XGBoost 分类器具有临床实用性。
XGBoost 构建的模型可预测 PDAC TILs,可能有助于免疫治疗的临床决策。