治疗前弥散峰度成像对晚期鼻咽癌无进展生存预测的预后价值

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-04-25 DOI:10.1002/cam4.70883

Wang Ren, Xiang Zheng, Shizhong Wu, Caixia Wu, Dechun Zheng

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引用次数: 0

摘要

目的探讨扩散峰度成像（DKI）对鼻咽癌（NPC）长期PFS的预后价值。方法选取295例鼻咽癌患者，采用DKI预处理3.0T MRI，计算平均峰度（MK）、平均弥散（MD）和表观弥散系数（ADC）。记录临床参数（肿瘤分期、EBV-DNA、新辅助化疗方案）。后续行动延长至2023年12月。统计分析（R软件v4.3.0）包括单因素/多因素Cox回归和Kaplan-Meier生存分析。综合关键预测因子的预后nomogram。结果中位10年随访显示，2年、5年和10年PFS分别为89%、79%和74%。单因素Cox回归分析显示，T分期、临床分期、NAC方案、ADC_Group、MK_Group、MD_Group是鼻咽癌PFS的重要预后因素（p < 0.05）。多因素分析确定临床分期（HR = 2.230, 95% CI 1.44-3.66, p < 0.001）、新辅助化疗方案（HR = 0.56, 95% CI 0.35-0.90, p = 0.017）和MK_Group （HR = 0.52, 95% CI 0.33-0.82, p = 0.003）为独立预后因素。MK_Group high组比MK_Group low组表现出更高的生存率(2年：94%对81%；5年：85% vs 66%；10年：79% vs. 64%；p < 0.05)。结合临床分期、NAC和MK_Group的nomogram预测2年、5年和10年PFS的准确度中等（AUC = 0.736, 0.718, 0.697）。结论预处理MK可作为鼻咽癌患者长期PFS的无创生物标志物。与临床分期和NAC方案的整合增强了预后分层，支持个性化的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Prognostic Value of Pre-Treatment Diffusion Kurtosis Imaging for Progression-Free Survival Prediction in Advanced Nasopharyngeal Carcinoma

查看原文本刊更多论文

Prognostic Value of Pre-Treatment Diffusion Kurtosis Imaging for Progression-Free Survival Prediction in Advanced Nasopharyngeal Carcinoma

Purpose

This study aimed to evaluate the value of diffusion kurtosis imaging (DKI) for prognostic value for long-term PFS in nasopharyngeal carcinoma (NPC).

Methods

A cohort of 295 NPC patients underwent pretreatment 3.0T MRI with DKI to derive mean kurtosis (MK), mean diffusion (MD), and apparent diffusion coefficient (ADC). Clinical parameters (Tumor stage, EBV-DNA, neoadjuvant chemotherapy regimens) were recorded. Follow-up extended to December 2023. Statistical analyses (R software v4.3.0) included univariate/multivariate Cox regression and Kaplan–Meier survival analysis. A prognostic nomogram integrating key predictors was developed.

Results

Median 10-year follow-up revealed 2-, 5-, and 10-year PFS rates of 89%, 79%, and 74%, respectively. Univariate Cox regression analysis demonstrated that T stage, Clinical Stages, NAC regimens, ADC_Group, MK_Group, and MD_Group were significant prognostic factors for PFS in NPC (p < 0.05). Multivariate analysis identified Clinical Stage (HR = 2.230, 95% CI 1.44–3.66, p < 0.001), NAC (neoadjuvant chemotherapy) regimens (HR = 0.56, 95% CI 0.35–0.90, p = 0.017), and MK_Group (HR = 0.52, 95% CI 0.33–0.82, p = 0.003) as independent prognostic factors. The MK_Group high exhibited superior survival rates versus MK_Group low (2-year: 94% vs. 81%; 5-year: 85% vs. 66%; 10-year: 79% vs. 64%; all p < 0.05). The nomogram combining Clinical Stage, NAC, and MK_Group demonstrated moderate predictive accuracy for 2-, 5-, and 10-year PFS (AUC = 0.736, 0.718, 0.697).

Conclusion

Pretreatment MK serves as a robust noninvasive biomarker for long-term PFS in NPC. Integration with Clinical Stage and NAC regimens enhances prognostic stratification, supporting personalized therapeutic strategies.

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.