基于多参数磁共振的影像组学特征一致性聚类与早期宫颈癌临床及组织病理学特征的相关性研究  

Correlation between consensus clustering for multiparametric MRI⁃based radiomics features and clinical and histopathological features of early⁃stage cervical cancer

作　　者：陆遥 邵文慧 宋佳成 张爱宁 段绍峰 曲菲菲 程文俊[4] 陈婷[1] 吴飞云[1] LU Yao;SHAO Wenhui;SONG Jiacheng;ZHANG Aining;DUAN Shaofeng;QU Feifei;CHENG Wenjun;CHEN Ting;WU Feiyun(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Central Research Institute,UIH Group,Shanghai 201800;MR Research Collaboration,Siemens Healthineers,Shanghai 200082;Department of Gynaecology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]联影医疗中央研究院,上海201800 [3]西门子医疗磁共振研究合作中心,上海200082 [4]南京医科大学第一附属医院妇科,江苏南京210029

出　　处：《南京医科大学学报(自然科学版)》2025年第2期208-217,共10页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科教能力提升工程(JSDW202243)。

摘　　要：目的:探讨早期宫颈癌患者的MRI影像表型与各种临床及组织病理学特征之间的相关性。方法:回顾性收集2019年7月—2023年12月164例早期宫颈癌患者的磁共振影像组学特征和临床及组织病理学特征。将所有患者的肿瘤和盆腔淋巴结通过基于影像组学特征的一致性聚类分为两组,比较两组患者的临床及组织病理学特征的差异。结果:基于肿瘤的聚类分析显示,两组在平均年龄、组织学类型、肿瘤分化程度、淋巴血管间隙侵犯以及宫旁浸润上差异均没有统计学意义。与组1相比,组2患者的术后国际妇产科联盟(Federation International of Gynecology and Obstetrics,FIGO)分期更晚[ⅡA期及以上:22/72(30.6%)vs.56/92(60.9%),P=0.001]、淋巴结转移的概率更大[9/72(12.5%)vs.30/92(32.6%),P=0.002]、肿瘤更大[短径:(16.67±6.32)mm vs.(28.38±9.73)mm,长径:(21.02±7.39)mm vs.(34.34±9.72)mm,高度:(18.93±8.01)mm vs.(29.92±10.61)mm,P均<0.001],且具有更深的间质浸润深度[>2/3:26/72(36.1%)vs.62/92(67.4%),P<0.001]。基于淋巴结的聚类分析显示两组在短径、长径、短长比、信号、边缘和淋巴结转移差异没有统计学意义。结论:基于肿瘤的多参数磁共振影像组学一致性聚类分析有助于识别早期宫颈癌患者影像组学特征与临床及组织病理学特征的关联,从而为术前危险分层提供了依据。Objective:To investigate the correlation between MRI phenotypes and various clinical and histopathological characteristics in patients with early⁃stage cervical cancer(CC).Methods:The MRI radiomics features,along with clinical and histopathological characteristics of 164 patients with CC were collected retrospectively from July 2019 to December 2023.Tumors and pelvic lymph nodes of all patients were divided into two clusters using raidomics⁃based consensus clustering.Differences in clinical and histopathological characteristics between the two groups were compared.Results:Tumor⁃based clustering analysis showed no significant differences between the two groups in terms of average age,histological type,tumor differentiation,lymphovascular space invasion,or parametrial invasion.Clustering analysis based on tumors showed that compared with the cluster 1,patients in the cluster 2 had a more advanced postoperative International Federation of Gynecology and Obstetrics(FIGO)stage[ⅡA and above:22/72(30.6%)vs.56/92(60.9%),P=0.001],a higher probability of lymph node metastasis[9/72(12.5%)vs.30/92(32.6%),P=0.002],larger tumor size[short diameter:(16.67±6.32)mm vs.(28.38±9.73)mm,long diameter:(21.02±7.39)mm vs.(34.34±9.72)mm,height:(18.93±8.01)mm vs.(29.92±10.61)mm,all P<0.001],and deeper stromal invasion[>2/3:26/72(36.1%)vs.62/92(67.4%),P<0.001].Clustering analysis based on lymph nodes showed that no significant differences between the two clusters in short axis,long axis,short⁃to⁃long axis ratio,signal,border,or lymph node metastasis.Conclusion:Associations between radiomics features and clinical and histopathological characteristics of patients with CC could be identified by consensus clustering based on multiparametric MRI⁃based radiomics,suggesting possibilities for preoperative risk stratification.

关 键 词：宫颈癌 磁共振成像 影像组学 一致性聚类 

分 类 号：R445.2[医药卫生—影像医学与核医学]