de Oliveira Lays Assolini Pinheiro, Peresi Caio Elias Irajaya Lobo, Nozaki Daniel Vitor Aguiar, Costa Ericka Francislaine Dias, Santos Lana Ferreira, Lima Carmen Silvia Passos, Lopes Sérgio Lúcio Pereira de Castro, Costa Andre Luiz Ferreira
Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil.
Postgraduate Program in Dentistry, Dentomaxillofacial Radiology and Imaging Laboratory, Department of Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo 01506-000, SP, Brazil.
Cancers (Basel). 2025 Jul 11;17(14):2317. doi: 10.3390/cancers17142317.
Texture analysis (TA) has shown promise in characterizing intratumoral heterogeneity from imaging data. We add to the literature that shows its capability to differentiate oropharyngeal cancers based on HPV status.
Multislice CT analysis was done in 120 patients with confirmed OP SCC: a single 5 mm region of interest was placed on three consecutive homogeneous CT slices per patient. Texture features were extracted by using gray-level co-occurrence matrices averaged per patient. HPV status (via p16 IHC and molecular confirmation) and differentiation grade (i.e., good, moderate, and poor) were recorded. Non-parametric statistical tests assessed differences between subgroups.
Seven texture parameters (i.e., angular second moment, contrast, sum of squares, sum entropy, entropy, inverse difference moment, and difference variance) differed significantly between HPV+ and HPV- tumors (all < 0.05). HPV+ tumors exhibited increased heterogeneity and complexity on CT imaging. No texture feature correlated with histological grade.
This study adds to the growing evidence that CT-based TA can assess HPV status in OP SCC. TA may be promising, though it requires further validation as an adjunctive method integrating into radiomics workflows to develop predictive models for diagnosis, prognosis, and treatment planning.
纹理分析（TA）已显示出从成像数据中表征肿瘤内异质性的潜力。我们补充了相关文献，这些文献表明其有能力根据人乳头瘤病毒（HPV）状态区分口咽癌。
对120例确诊为口咽鳞状细胞癌（OP SCC）的患者进行多层CT分析：每位患者在连续三个均匀的CT切片上放置一个5毫米的感兴趣区域。使用每位患者平均的灰度共生矩阵提取纹理特征。记录HPV状态（通过p16免疫组化和分子确认）和分化程度（即高分化、中分化和低分化）。非参数统计检验评估亚组之间的差异。
七个纹理参数（即角二阶矩、对比度、平方和、和熵、熵、逆差矩和差方差）在HPV阳性和HPV阴性肿瘤之间存在显著差异（均P<0.05）。HPV阳性肿瘤在CT成像上表现出更高的异质性和复杂性。没有纹理特征与组织学分级相关。
本研究进一步证明基于CT的TA可以评估OP SCC中的HPV状态。TA可能具有前景，尽管它需要作为一种辅助方法进一步验证，以纳入放射组学工作流程，从而开发用于诊断、预后和治疗规划的预测模型。
