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基于术前CT的形态学异质性预测结直肠癌肝转移患者手术切除后的生存情况：一项回顾性研究

Preoperative CT-based morphological heterogeneity for predicting survival in patients with colorectal cancer liver metastases after surgical resection: a retrospective study.

作者信息

Xing Qian, Cui Yong, Liu Ming, Gu Xiao-Lei, Li Xiao-Ting, Xing Bao-Cai, Sun Ying-Shi

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatopancreatobiliary Surgery Department I, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China.

出版信息

BMC Med Imaging. 2024 Dec 18;24(1):343. doi: 10.1186/s12880-024-01524-w.

DOI:10.1186/s12880-024-01524-w
PMID:39696033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11657693/
Abstract

OBJECTIVE

To explore the value of preoperative CT-based morphological heterogeneity (MH) for predicting local tumor disease-free survival (LTDFS) and progression-free survival (PFS) in patients with colorectal cancer liver metastases (CRLM).

METHODS

The latest CT data of 102 CRLM patients were retrospectively analyzed. The morphological score of each liver metastasis was obtained, and the morphological heterogeneity difference (MHD) was calculated. The receiver operating characteristic (ROC) curve was drawn, and the cutoff value was found. The Kaplan-Meier method was used to draw survival curves of patients with or without MH. The Cox regression analysis was used to build the model with MH and clinical characteristics for predicting PFS.

RESULTS

In 78 patients without MH, median PFS was 9.0 months (95% CI:6.5-11.5), while in 24 patients with MH, median PFS was 6.0 months (95% CI:4.0-8.1), indicating that MH significantly affected PFS (p = 0.001). MH affected PFS in both the chemotherapy group and the chemotherapy combined with targeted therapy group (p = 0.005, p = 0.043). MH, preoperative carcinoembryonic antigen (CEA) and chemotherapy after surgery were independent predictors for postoperative PFS in patients with CRLM.

CONCLUSION

Preoperative CT-based MH had good efficacy for predicting LTDFS and PFS of CRLM patients after surgical resection, regardless of preoperative treatment. MH is one of the independent predictors of PFS.

摘要

目的

探讨基于术前CT的形态学异质性（MH）对预测结直肠癌肝转移（CRLM）患者局部无瘤生存（LTDFS）和无进展生存（PFS）的价值。

方法

回顾性分析102例CRLM患者的最新CT数据。获得每个肝转移灶的形态学评分，并计算形态学异质性差异（MHD）。绘制受试者工作特征（ROC）曲线并找到截断值。采用Kaplan-Meier法绘制有或无MH患者的生存曲线。采用Cox回归分析建立包含MH和临床特征的预测PFS的模型。

结果

78例无MH患者的中位PFS为9.0个月（95%CI：6.5-11.5），而24例有MH患者的中位PFS为6.0个月（95%CI：4.0-8.1），表明MH显著影响PFS（p = 0.001）。MH在化疗组和化疗联合靶向治疗组中均影响PFS（p = 0.005，p = 0.043）。MH、术前癌胚抗原（CEA）和术后化疗是CRLM患者术后PFS的独立预测因素。

结论

基于术前CT的MH对预测手术切除后CRLM患者的LTDFS和PFS具有良好效果，无论术前治疗情况如何。MH是PFS的独立预测因素之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/0d81f8e65ead/12880_2024_1524_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/a7462d113c5a/12880_2024_1524_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/90bc898210b0/12880_2024_1524_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/2f50d415d8c1/12880_2024_1524_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/b78a0b4b1834/12880_2024_1524_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/d3c14b71784f/12880_2024_1524_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/0d81f8e65ead/12880_2024_1524_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/a7462d113c5a/12880_2024_1524_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/90bc898210b0/12880_2024_1524_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/2f50d415d8c1/12880_2024_1524_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/b78a0b4b1834/12880_2024_1524_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/d3c14b71784f/12880_2024_1524_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8af/11657693/0d81f8e65ead/12880_2024_1524_Fig6_HTML.jpg

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