数字乳腺断层摄影影像组学联合临床预测乳腺浸润性导管癌分子类型  

Digital breast tomosynthesis radiomics combined with clinical data for predicting molecular type of breast invasive ductal carcinoma

作　　者：陈琪 顾梦瑶 刘丽 戚佳佳 李万湖 CHEN Qi;GU Mengyao;LIU Li;QI Jiajia;LI Wanhu(Department of Radiology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China)

机构地区：[1]山东省肿瘤防治研究院(山东省肿瘤医院),山东第一医科大学(山东省医学科学院)影像科,山东济南250117

出　　处：《中国介入影像与治疗学》2025年第2期107-111,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：人工智能分子功能影像指导乳腺癌个体化新辅助化疗疗效评估(320.6750.2023-18-111)。

摘　　要：目的观察数字乳腺断层摄影(DBT)影像组学联合临床预测乳腺浸润性导管癌(IDC)分子类型的价值。方法回顾性分析309例Luminal型及97例非Luminal型女性IDC患者,按7∶3比例将其分为训练集(n=284)与测试集(n=122)。采用多因素logistic回归分析针对临床资料及DBT所见筛选乳腺IDC Luminal表达相关的独立影响因素,构建临床-影像学模型;基于内外斜位DBT构建影像组学模型,以之联合临床-影像学模型构建联合模型。绘制受试者工作特征曲线,计算曲线下面积(AUC),评估各模型预测乳腺IDC分子类型的效能。结果病理组织学级别及DBT所示病灶边缘分别为乳腺IDC Luminal表达相关的临床及影像学独立影响因素(P均<0.05)。联合模型预测训练集、测试集乳腺IDC分子类型的AUC分别为0.821、0.715,高于临床-影像学模型(0.727、0.665)及影像组学模型(0.776、0.663)(P均<0.05);而临床-影像学模型与影像组学模型差异均无统计学意义(P均>0.05)。结论DBT影像组学联合临床有助于预测乳腺IDC分子类型。Objective To observe the value of digital breast tomosynthesis(DBT)radiomics combined with clinical data for predicting molecular type of breast invasive ductal carcinoma(IDC).Methods Totally 309 female patients with Luminal type and 97 with non-Luminal type breast IDC were retrospectively enrolled and divided into training set(n=284)and test set(n=122)at a ratio of 7∶3.Multivariate logistic regression analysis was performed to screen independent impact factors related to Luminal expression of breast IDC based on clinical data and DBT manifestations,then a clinicalimaging model was constructed.The radiomics model was established based on mediolateral oblique position of DBT images,and a combined model was conducted combining with clinical-imaging model and radiomics model.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting molecular type of breast IDC.Results Histopathological grade and lesion margin showed on DBT was the clinical and imaging independent impact factor associated with Luminal expression of breast IDC,respectively(both P<0.05).AUC of combined model for predicting molecular type of breast IDC in training set and test set was 0.821 and 0.715,respectively,both higher than clinical-imaging model(0.727 and 0.665)and radiomics model(0.776 and 0.663)(all P<0.05),while no significant difference was found between clinical-imaging model and radiomics model(both P>0.05).Conclusion DBT radiomics combined with clinical data was helpful for predicting molecular type of breast IDC.

关 键 词：乳腺肿瘤 乳房X线摄影术 影像组学 分子分型 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]