胰腺癌空间构型与新辅助治疗和根治性切除术后疾病复发相关
Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.
从标准H&E切片量化的残留癌-间质拓扑结构在PDAC新辅助治疗后产生独立预后信号,为空间风险提供细胞免疫相关性依据,并推动前瞻性验证及空间信息指导的辅助治疗策略。
英文原题:Machine Learning for Computed Tomography Radiomics: Prediction of Tumor-Infiltrating Lymphocytes in Patients With Pancreatic Ductal Adenocarcinoma.
基于 XGBoost 的模型可预测胰腺导管腺癌的 TILs,并可能促进免疫治疗的临床决策。
目的:开发并验证一种机器学习分类器,用于术前预测胰腺导管腺癌(PDAC)患者的TIL(肿瘤浸润淋巴细胞)。方法:本回顾性研究纳入183例接受多排计算机断层扫描及手术切除的PDAC患者,通过免疫组化评估CD4阳性、CD8阳性和CD20阳性表达,并采用Cox回归模型计算TIL评分。患者分为TIL低组和TIL高组。研究者使用连续纳入的136例患者构建极端梯度提升(XGBoost)分类器,并在另47例连续纳入患者中验证模型,评估其区分能力、校准度及临床效用。结果:该预测模型在训练集和验证集中均具有良好区分能力,曲线下面积分别为0.93(95%置信区间0.89–0.97)和0.79(95%置信区间0.65–0.92),且校准良好。训练集的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为0.93、0.85、0.90、0.89和0.91;验证集相应指标分别为0.63、0.91、0.77、0.88和0.70。结论:基于XGBoost的模型可预测PDAC中的TIL水平,并可能辅助免疫治疗临床决策。
OBJECTIVES: The aims of the study were to develop and validate a machine learning classifier for preoperative prediction of tumor-infiltrating lymphocytes (TILs) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: In this retrospective study of 183 PDAC patients who underwent multidetector computed tomography and surgical resection, CD4 + , CD8 + , and CD20 + expression was evaluated using immunohistochemistry, and TIL scores were calculated using the Cox regression model. The patients were divided into TIL-low and TIL-high groups. An extreme gradient boosting (XGBoost) classifier was developed using a training set consisting of 136 consecutive patients, and the model was validated in 47 consecutive patients. The discriminative ability, calibration, and clinical utility of the XGBoost classifier were evaluated. RESULTS: The prediction model showed good discrimination in the training (area under the curve, 0.93; 95% confidence interval, 0.89-0.97) and validation (area under the curve, 0.79; 95% confidence interval, 0.65-0.92) sets with good calibration. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for the training set were 0.93, 0.85, 0.90, 0.89, and 0.91, respectively, while those for the validation set were 0.63, 0.91, 0.77, 0.88, and 0.70, respectively. CONCLUSIONS: The XGBoost-based model could predict PDAC TILs and may facilitate clinical decision making for immune therapy.
MEMBER ACCOUNT
登录成功会直接打开下一页。