Objective: To develop and validate a radiomics-based predictive risk score(RPRS) for preoperative prediction of lymph node(LN) metastasis in patients with resectable non-small cell lung cancer(NSCLC).Methods: We retro...Objective: To develop and validate a radiomics-based predictive risk score(RPRS) for preoperative prediction of lymph node(LN) metastasis in patients with resectable non-small cell lung cancer(NSCLC).Methods: We retrospectively analyzed 717 who underwent surgical resection for primary NSCLC with systematic mediastinal lymphadenectomy from October 2007 to July 2016. By using the method of radiomics analysis, 591 computed tomography(CT)-based radiomics features were extracted, and the radiomics-based classifier was constructed. Then, using multivariable logistic regression analysis, a weighted score RPRS was derived to identify LN metastasis. Apparent prediction performance of RPRS was assessed with its calibration,discrimination, and clinical usefulness.Results: The radiomics-based classifier was constructed, which consisted of 13 selected radiomics features.Multivariate models demonstrated that radiomics-based classifier, age group, tumor diameter, tumor location, and CT-based LN status were independent predictors. When we assigned the corresponding score to each variable,patients with RPRSs of 0-3, 4-5, 6, 7-8, and 9 had distinctly very low(0%-20%), low(21%-40%), intermediate(41%-60%), high(61%-80%), and very high(81%-100%) risks of LN involvement, respectively. The developed RPRS showed good discrimination and satisfactory calibration (C-index: 0.785, 95% confidence interval(95% CI):0.780-0.790)Additionally, RPRS outperformed the clinicopathologic-based characteristics model with net reclassification index(NRI) of 0.711(95% CI: 0.555-0.867).Conclusions: The novel clinical scoring system developed as RPRS can serve as an easy-to-use tool to facilitate the preoperatively individualized prediction of LN metastasis in patients with resectable NSCLC. This stratification of patients according to their LN status may provide a basis for individualized treatment.展开更多
Background: The associations between the severity of interstitial lung disease and the stage and histologic type of concurrent lung cancer remain unknown. Purpose: To evaluate whether the severity of interstitial lung...Background: The associations between the severity of interstitial lung disease and the stage and histologic type of concurrent lung cancer remain unknown. Purpose: To evaluate whether the severity of interstitial lung abnormality (ILA), as indicated by quantitative computed tomographic (CT) indexes and CT visual score, was correlated with the stage and histological type of concurrent lung cancer. Materials and Methods: Twenty-eight patients with surgically diagnosed lung cancer and ILA on CT were enrolled in this retrospective study. The subjects were allocated to one of three groups by histological type: adenocarcinoma group (13 subjects);squamous cell carcinoma group (10 subjects);and the other histological diagnosis group (5 subjects). Two independent observers evaluated the CT findings to determine the CT visual score, and the kurtosis and skewness of CT-based density histograms were determined. The relationships between severity of ILA and the pathological stage and histological type of concurrent lung cancer were evaluated. Results: There were no significant differences in the CT visual scores and quantitative indexes among the three groups. CT visual score was significantly negatively correlated with pathological stage (r = −0.43, P = 0.025). Conclusion: Patients can have only mild ILA on visual scoring but advanced lung cancer. Therefore, the frequency of follow-up examination should not be based on the severity of ILA on CT.展开更多
基金supported by the National Key Research and Development Plan of China (No. 2017YFC1309100)the National Natural Scientific Foundation of China (No. 81771912, 81901910, and 81701782)the Provincial Science and Technology Plan Project of Guangdong Province (No. 2017B020227012)
文摘Objective: To develop and validate a radiomics-based predictive risk score(RPRS) for preoperative prediction of lymph node(LN) metastasis in patients with resectable non-small cell lung cancer(NSCLC).Methods: We retrospectively analyzed 717 who underwent surgical resection for primary NSCLC with systematic mediastinal lymphadenectomy from October 2007 to July 2016. By using the method of radiomics analysis, 591 computed tomography(CT)-based radiomics features were extracted, and the radiomics-based classifier was constructed. Then, using multivariable logistic regression analysis, a weighted score RPRS was derived to identify LN metastasis. Apparent prediction performance of RPRS was assessed with its calibration,discrimination, and clinical usefulness.Results: The radiomics-based classifier was constructed, which consisted of 13 selected radiomics features.Multivariate models demonstrated that radiomics-based classifier, age group, tumor diameter, tumor location, and CT-based LN status were independent predictors. When we assigned the corresponding score to each variable,patients with RPRSs of 0-3, 4-5, 6, 7-8, and 9 had distinctly very low(0%-20%), low(21%-40%), intermediate(41%-60%), high(61%-80%), and very high(81%-100%) risks of LN involvement, respectively. The developed RPRS showed good discrimination and satisfactory calibration (C-index: 0.785, 95% confidence interval(95% CI):0.780-0.790)Additionally, RPRS outperformed the clinicopathologic-based characteristics model with net reclassification index(NRI) of 0.711(95% CI: 0.555-0.867).Conclusions: The novel clinical scoring system developed as RPRS can serve as an easy-to-use tool to facilitate the preoperatively individualized prediction of LN metastasis in patients with resectable NSCLC. This stratification of patients according to their LN status may provide a basis for individualized treatment.
文摘Background: The associations between the severity of interstitial lung disease and the stage and histologic type of concurrent lung cancer remain unknown. Purpose: To evaluate whether the severity of interstitial lung abnormality (ILA), as indicated by quantitative computed tomographic (CT) indexes and CT visual score, was correlated with the stage and histological type of concurrent lung cancer. Materials and Methods: Twenty-eight patients with surgically diagnosed lung cancer and ILA on CT were enrolled in this retrospective study. The subjects were allocated to one of three groups by histological type: adenocarcinoma group (13 subjects);squamous cell carcinoma group (10 subjects);and the other histological diagnosis group (5 subjects). Two independent observers evaluated the CT findings to determine the CT visual score, and the kurtosis and skewness of CT-based density histograms were determined. The relationships between severity of ILA and the pathological stage and histological type of concurrent lung cancer were evaluated. Results: There were no significant differences in the CT visual scores and quantitative indexes among the three groups. CT visual score was significantly negatively correlated with pathological stage (r = −0.43, P = 0.025). Conclusion: Patients can have only mild ILA on visual scoring but advanced lung cancer. Therefore, the frequency of follow-up examination should not be based on the severity of ILA on CT.
