肿瘤全域ADC直方图预测舌鳞状细胞癌PD-L1表达的研究  

Preliminary study on prediction of PD-L1 expression in tongue squamous cell carcinoma by tumor global ADC histogram

作　　者：罗舒艳 胡子洋 孙国文[2] 高娜 林梓桐[1] LUO Shu-yan;HU Zhi-yang;SUN Guo-wen(Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院/南京市口腔医院口腔颌面医学影像科,南京210008 [2]南京大学医学院附属口腔医院/南京市口腔医院口腔颌面外科,南京210008

出　　处：《放射学实践》2023年第6期699-704,共6页Radiologic Practice

摘　　要：目的:探讨核磁共振成像DWI序列表观扩散系数(ADC)的直方图参数对舌癌原发灶中肿瘤细胞PD-L1表达高低的鉴别效能。方法:回顾性分析23例术前行MRI检查并经组织病理证实为舌鳞状细胞癌(TSCC)的患者资料。将扩散敏感系数(b值)为1000 s/mm 2的DWI序列图像生成的ADC图像导入至3D Slicer软件中,勾画肿瘤全层的病灶边界,生成3D感兴趣区(ROI),经软件的Radiomics模块提取ADC直方图参数,包括能量ADC Energy、总能量ADC Total Energy、熵ADC Entropy、最小值ADC Min、最大值ADC Max、第十百分位数ACD 10th、第九十百分位ADC 90th、最大值Max、均值ADC Mean、中值ADC Median、四分位距ADC Interquartile Range、极差ADC Range、平均绝对离差ADC MAD、ADC鲁棒平均绝对离差ADC rMAD、均方根ADC RMS、偏度ADC Skewness、峰度ADC Kurtosis、方差ADC Variance、均匀性ADC Uniformity。通过免疫组化技术对舌癌组织切片进行PD-L1染色,对肿瘤细胞上PD-L1的表达进行评分。统计学分析PD-L1高低表达组间的ADC直方图参数的差异性。结果:方差ADC Variance、四分位距ADC Interquartile Range、平均绝对离差ADC MAD、鲁棒平均绝对离差ADC rMAD,在PD-L1高低表达组中差异具有统计学意义(P<0.05)。各参数在ROC曲线上的AUC值分别为0.754、0.762、0.754、0.762;灵敏度分别为84.6%、69.2%、84.6%、76.9%;特异度分别为70.0%、80.0%、70.0%、70.0%。结论:基于肿瘤全域的ADC直方图参数在鉴别TSCC中肿瘤细胞PD-L1的表达中具有良好的效能,有望成为无创预测TSCC中PD-L1表达差异的影像成像标志物。Objective:To explore the differential efficacy of histogram parameters of apparent diffusion coefficient(ADC)of nuclear magnetic resonance imaging DWI sequence on the expression of PD-L1 in primary lesions of tongue squamous cell carcinoma(TSCC).Methods:The data of 23 patients with tongue squamous cell carcinoma confirmed by histopathology and preoperative MRI were analyzed retrospectively.The ADC image generated from DWI sequence images with diffusion sensitivity coefficient(b value)of 1000s/mm 2 is imported into 3D slicer software to outline the lesion boundary of the whole layer of the tumor and generate 3D region of interest(ROI).The ADC histogram parameters are extracted by the radiology module of the software,including ADC Energy,ADC Total Energy,ADC Entropy,ADC Min,ADC Max,ADC 10th,ADC 90th,Max,ADC Mean,ADC Median,ADC InterquartileRange,ADC Range,ADC MAD,ADC rMAD,ADC RMS,ADC Skewness,ADC Kurtosis,ADC Variance,ADC Uniformity.PD-L1 staining was performed on the tissue sections of tongue cancer by immunohistochemical technique,and the expression of PD-L1 on tumor cells was scored.The differences of ADC histogram parameters between PD-L1 high and low expression groups were statistically analyzed.Results:ADC Variance,ADC Interquartile Range,ADC MAD,ADC rMAD were statistically significant in PD-L1 high and low expression groups(P<0.05).The AUC values of each parameter on the ROC curve are 0.754,0.762,0.754 and 0.762,respectively;The sensitivity was 84.6%,69.2%,84.6%and 76.9%,respectively;The specificity was 70.0%,80.0%,70.0%and 70.0%,respectively.Conclusion:The ADC histogram parameters based on the whole tumor domain have high efficiency in identifying the expression of PD-L1 in tumor cells in TSCC,and are expected to become an imaging marker for noninvasive prediction of the difference of PD-L1 expression in TSCC.

关 键 词：舌肿瘤 磁共振成像 直方图分析 

分 类 号：R739.86[医药卫生—肿瘤] R445.2[医药卫生—临床医学]