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Magnetic Resonance Features of Lower-grade Gliomas in Prediction of the Reverse Phase Protein A.
反相蛋白A预测低级别胶质瘤的磁共振特征。
- 影响因子:1.48
- DOI:10.1097/RCT.0000000000001132
- 作者列表:"Wang J","Guo X
- 发表时间:2021-03-01
Abstract
OBJECTIVES:The Cancer Genome Atlas Research Network identified 4 novel protein expression-defined subgroups in patients with lower-grade gliomas (LGGs). The RPPA3 subtype had high levels of Epidermal Growth Factor Receptor and Human epidermal growth factor receptor-2, further increasing the chances for targeted therapy. In this study, we aimed to explore the relationships between magnetic resonance features and reverse phase protein array (RPPA) subtypes (R1-R4). METHODS:Survival estimates for the Cancer Genome Atlas cohort were generated using the Kaplan-Meier method and time-dependent receiver operating characteristic curves. A total of 153 patients with LGG with brain magnetic resonance imaging from The Cancer Imaging Archive were retrospectively analyzed. Least absolute shrinkage and selection operator algorithm was used to reduce the feature dimensions of the RPPA3 subtype. RESULTS:A total of 51 (33.3%) RPPA1 subtype, 42 (27.4) RPPA2 subtype, 19 (12.4%) RPPA3 subtype, and 38 (24.8%) RPPA4 subtype were identified. On multivariate logistic regression analysis, subventricular zone involvement [odds ratio (OR), 0.370; P = 0.006; 95% confidence interval (CI), 0.181-0.757) was associated with RPPA1 subtype [area under the curve (AUC), 0.598]. Volume of 60 cm3 or greater (OR, 5.174; P < 0.001; 95% CI, 2.182-12.267) was associated with RPPA2 subtype (AUC, 0.684). Proportion contrast-enhanced tumor greater than 5% (OR, 4.722; P = 0.010; 95% CI, 1.456-15.317), extranodular growth (OR, 5.524; P = 0.010; 95% CI, 1.509-20.215), and L/CS ratio equal to or greater than median (OR, 0.132; P = 0.003; 95% CI, 0.035-0.500) were associated with RPPA3 subtype (AUC, 0.825). Proportion contrast-enhanced tumor greater than 5% (OR, 0.206; P = 0.005; 95% CI, 0.068-0.625) was associated with RPPA4 subtype (AUC, 0.638). For the prediction of RPPA3 subtype, the nomogram showed good discrimination, with an AUC of 0.825 (95% CI, 0.711-0.939) and was well calibrated. The RPPA3 subtype was associated with shortest mean overall survival (RPPA3 subtype vs other: 613 vs 873 days; P < 0.05). The time-dependent receiver operating characteristic curves for the RPPA3 subtype was 0.72 (95% CI, 0.60-0.84) for survival at 1 year. Decision curve analysis indicated that prediction for the RPPA3 model was clinically useful. CONCLUSIONS:The RPPA3 subtype is an unfavorable prognostic biomarker for overall survival in patients with LGG. Radiogenomics analysis of magnetic resonance features can predict the RPPA subtype preoperatively and may be of clinical value in tailoring the management strategies in patients with LGG.
摘要
目的: 癌症基因组图谱研究网络在低级别胶质瘤 (LGGs) 患者中发现了4个新的蛋白表达确定的亚组。RPPA3亚型具有高水平的表皮生长因子受体和人表皮生长因子受体-2,进一步增加了靶向治疗的机会。在这项研究中,我们旨在探讨磁共振特征和反相蛋白阵列 (RPPA) 亚型之间的关系 (R1-R4)。 方法: 使用Kaplan-Meier方法和时间依赖性接受者操作特征曲线生成癌症基因组图谱队列的存活估计。回顾性分析来自癌症影像档案的153例LGG患者的脑磁共振成像。使用最小绝对收缩和选择算子算法来减小RPPA3亚型的特征维度。 结果: 共鉴定了51 (33.3%) 个RPPA1亚型、42 (27.4) 个RPPA2亚型、19 (12.4%) 个RPPA3亚型和38 (24.8%) 个RPPA4亚型。在多变量logistic回归分析中,心室下区受累 [比值比 (OR),0.370; P = 0.006; 95% 置信区间 (CI),0.181-0.757) 与RPPA1亚型 [曲线下面积 (AUC),0.598] 相关。60立方厘米或更大的体积 (or,5.174; P < 0.001; 95% CI,2.182-12.267) 与RPPA2亚型相关 (AUC,0.684)。对比增强肿瘤比例大于5% (OR,4.722; P = 0.010; 95% CI,1.456-15.317),结节外生长 (OR,5.524; P = 0.010; 95% CI,1.509-20.215),L/CS比值等于或大于中位数 (or,0.132; P = 0.003; 95% CI,0.035-0.500)与RPPA3亚型相关 (AUC,0.825)。对比增强肿瘤比例大于5% (OR,0.206; P = 0.005; 95% CI,0.068-0.625) 与RPPA4亚型相关 (AUC,0.638)。对于RPPA3亚型的预测,列线图显示出良好的区分度,AUC为0.825 (95% CI,0.711-0.939),并且校准良好。RPPA3亚型与最短平均总生存期相关 (RPPA3亚型vs其他: 613 vs 873天; P <0.05)。RPPA3亚型的时间依赖性受试者工作特征曲线为1年生存率的0.72 (95% CI,0.60-0.84)。决策曲线分析表明RPPA3模型的预测在临床上是有用的。 结论: RPPA3亚型是LGG患者总生存期的不良预后生物标志物。磁共振特征的放射基因组学分析可以在术前预测RPPA亚型,并可能对LGG患者定制管理策略具有临床价值。
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