用于预测鼻咽癌程序性死亡配体 1 表达的定量表观扩散系数测量的可重复性和实用性。
Reproducibility and usefulness of quantitative apparent diffusion coefficient measurements for predicting program death-ligand 1 expression in nasopharyngeal carcinoma.
机构信息
Department of Medical Imaging, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095, China.
Department of Otolaryngology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
出版信息
Cancer Imaging. 2023 Oct 12;23(1):98. doi: 10.1186/s40644-023-00587-2.
BACKGROUND
Accurate assessment of programmed death-ligand 1 (PD-L1) expression status in nasopharyngeal carcinoma (NPC) before immunotherapy is crucial. We aimed to explore the reproducibility and usefulness of the quantitative apparent diffusion coefficient (ADC) measurements for predicting PD-L1expression status in NPC.
METHODS
We retrospectively recruited 134 NPC patients who underwent MRI scans and PD-L1 detection. A PD-L1 combined positive score (CPS) ≥ 20 was identified as high expression status. Patients were divide into two cohorts based on the MRI scanning devices, including a 1.5-T MRI cohort (n = 85, 44 PD-L1 high expression) and a 3.0-T MRI cohort (n = 49, 24 PD-L1 high expression). The mean ADC (ADC), minimum ADC (ADC) and maximal ADC (ADC) values were independently measured by two observers. The ADC measurement reproducibility was assessed by interclass correlation coefficients (ICC). The correlations between ADC parameters and CPS were analyzed by spearman's correlation coefficient (r), and the performance for PD-L1expression status prediction was assessed by the area under receiver operating characteristic curve (AUC).
RESULTS
The measurement reproducibility of ADC, ADC and ADC was good in the 1.5-T MRI cohort (ICC: 0.843-0.930) and 3.0-T MRI cohort (ICC: 0.929-0.960). The ADC, ADC, and ADC tended to inversely correlate with the CPS (r:-0.37 - -0.52 in the 1.5-T MRI cohort, and - 0.52 - -0.60 in the 3.0-T MRI cohort; P all < 0.01). The ADC, ADC and ADC yielded the AUC of 0.756 (95% CI: 0.651, 0.861), 0.689 (95% CI: 0.576, 0.802), and 0.733 (95%CI: 0.626, 0.839) in the 1.5-T MRI cohort and 0.820 (95%CI: 0.703, 0.937), 0.755 (95% CI: 0.616, 0.894), and 0.760 (95%CI: 0.627, 0.893) in the 3.0-T MRI cohort for predicting PD-L1 high expression status, respectively.
CONCLUSION
ADC measurements may act as a reproducible and feasible method to predict PD-L1 expression status in NPC.
背景
在免疫治疗前准确评估鼻咽癌（NPC）中程序性死亡配体 1（PD-L1）的表达状态至关重要。我们旨在探索定量表观扩散系数（ADC）测量在预测 NPC 中 PD-L1 表达状态方面的重现性和实用性。
方法
我们回顾性招募了 134 名接受 MRI 扫描和 PD-L1 检测的 NPC 患者。PD-L1 联合阳性评分（CPS）≥20 被认为是高表达状态。根据 MRI 扫描设备将患者分为两组，包括 1.5-T MRI 队列（n=85，44 例 PD-L1 高表达）和 3.0-T MRI 队列（n=49，24 例 PD-L1 高表达）。由两名观察者独立测量平均 ADC（ADC）、最小 ADC（ADC）和最大 ADC（ADC）值。采用组内相关系数（ICC）评估 ADC 测量的可重复性。采用 Spearman 相关系数（r）分析 ADC 参数与 CPS 的相关性，并通过受试者工作特征曲线（ROC）下面积（AUC）评估对 PD-L1 表达状态预测的性能。
结果
1.5-T MRI 队列（ICC：0.843-0.930）和 3.0-T MRI 队列（ICC：0.929-0.960）中 ADC、ADC 和 ADC 的测量重现性良好。ADC、ADC 和 ADC 与 CPS 呈负相关（1.5-T MRI 队列 r：-0.37 至-0.52，3.0-T MRI 队列 r：-0.52 至-0.60；P 均<0.01）。ADC、ADC 和 ADC 在 1.5-T MRI 队列中的 AUC 分别为 0.756（95%CI：0.651，0.861）、0.689（95%CI：0.576，0.802）和 0.733（95%CI：0.626，0.839），在 3.0-T MRI 队列中的 AUC 分别为 0.820（95%CI：0.703，0.937）、0.755（95%CI：0.616，0.894）和 0.760（95%CI：0.627，0.893），用于预测 PD-L1 高表达状态。
结论
ADC 测量值可能是一种可重复且可行的方法，可用于预测 NPC 中 PD-L1 的表达状态。
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