Wang Huihui, Xu Zeyan, Zhang Haochen, Huang Jia, Peng Haien, Zhang Yuan, Liang Changhong, Zhao Ke, Liu Zaiyi
Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Quant Imaging Med Surg. 2022 Sep;12(9):4402-4413. doi: 10.21037/qims-22-77.
Microsatellite instability (MSI) status can be used for the classification and risk stratification of endometrial cancer (EC). This study aimed to investigate whether magnetic resonance imaging (MRI)-based tumor shape features can help assess MSI status in EC before surgery.
The medical records of 88 EC patients with MSI status were retrospectively reviewed. Quantitative and subjective shape features based on MRI were used to assess MSI status. Variables were compared using the Student's -test, χ test, or Wilcoxon rank-sum test where appropriate. Univariate and multivariate analyses were performed by the logistic regression model. The area under the curve (AUC) was used to estimate the discrimination performance of variables.
There were 23 patients with MSI, and 65 patients with microsatellite stability (MSS) in this study. Eccentricity and shape type showed significant differences between MSI and MSS (P=0.039 and P=0.033, respectively). The AUC values of eccentricity, shape type, and the combination of 2 features for assessing MSI were 0.662 [95% confidence interval (CI): 0.554-0.770], 0.627 (95% CI: 0.512-0.743), and 0.727 (95% CI: 0.613-0.842), respectively. Considering the International Federation of Gynecology and Obstetrics (FIGO) staging, eccentricity maintained a significant difference in stages I-II (P=0.039), while there was no statistical difference in stages III-IV (P=0.601).
It is possible that MRI-based tumor shape features, including eccentricity and shape type, could be promising markers for assessing MSI status. The features may aid in the preliminary screening of EC patients with MSI.
微卫星不稳定性（MSI）状态可用于子宫内膜癌（EC）的分类和风险分层。本研究旨在探讨基于磁共振成像（MRI）的肿瘤形状特征是否有助于术前评估EC的MSI状态。
回顾性分析88例有MSI状态的EC患者的病历。基于MRI的定量和主观形状特征用于评估MSI状态。在适当情况下，使用学生t检验、χ检验或Wilcoxon秩和检验比较变量。通过逻辑回归模型进行单因素和多因素分析。曲线下面积（AUC）用于估计变量的判别性能。
本研究中有23例MSI患者和65例微卫星稳定（MSS）患者。MSI组和MSS组之间的偏心率和形状类型存在显著差异（分别为P = 0.039和P = 0.033）。用于评估MSI的偏心率、形状类型以及两者组合的AUC值分别为0.662 [95%置信区间（CI）：0.554 - 0.770]、0.627（95% CI：0.512 - 0.743）和0.727（95% CI：0.613 - 0.842）。考虑国际妇产科联盟（FIGO）分期，偏心率在I - II期保持显著差异（P = 0.039），而在III - IV期无统计学差异（P = 0.601）。
基于MRI的肿瘤形状特征，包括偏心率和形状类型，有可能成为评估MSI状态的有前景的标志物。这些特征可能有助于对MSI的EC患者进行初步筛查。
