Development and validation of a computed tomography-based immune ecosystem diversity index as an imaging biomarker in non-small cell lung cancer

被引:4
|
作者
He, Lan [1 ]
Li, Zhen-Hui [1 ,2 ]
Yan, Li-Xu [3 ]
Chen, Xin [4 ]
Sanduleanu, Sebastian [5 ,6 ]
Zhong, Wen-Zhao [7 ]
Lambin, Phillippe [5 ,6 ,8 ]
Ye, Zhao-Xiang [9 ]
Sun, Ying-Shi [10 ]
Liu, Yu-Lin [11 ]
Qu, Jin-Rong [12 ,13 ]
Wu, Lin [14 ]
Tu, Chang-Ling [15 ]
Scrivener, Madeleine [16 ]
Pieters, Thierry [17 ]
Coche, Emmanuel [18 ]
Yang, Qian [11 ]
Yang, Mei [19 ]
Liang, Chang-Hong [1 ,21 ]
Huang, Yan-Qi [1 ,20 ]
Liu, Zai-Yi [1 ,21 ]
机构
[1] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Radiol, 106 Zhongshan Er Rd, Guangzhou 510080, Peoples R China
[2] Kunming Med Univ, Affiliated Hosp 3, Yunnan Canc Hosp, Yunnan Canc Ctr,Dept Radiol, Kunming, Yunnan, Peoples R China
[3] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Pathol, Guangzhou, Peoples R China
[4] South China Univ Technol, Guangzhou Peoples Hosp 1, Sch Med, Dept Radiol, Guangzhou, Peoples R China
[5] Maastricht Univ, D Lab, Maastricht, Netherlands
[6] Maastricht Univ, GROW Sch Oncol, Dept Precis Med, M Lab, Maastricht, Netherlands
[7] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Lung Canc Inst, Guangzhou, Peoples R China
[8] Maastricht Univ, Med Ctr, GROW Sch Oncol & Dev Biol, Dept Radiol & Nucl Med, Maastricht, Netherlands
[9] Tianjin Med Univ Canc Inst & Hosp, Dept Radiol, Tianjin, Peoples R China
[10] Peking Univ Canc Hosp & Inst, Dept Radiol, Minist Educ Beijing, Key Lab Carcinogenesis & Translat Res, Beijing, Peoples R China
[11] Huazhong Univ Sci & Technol, Hubei Canc Hosp, Tongji Med Coll, Dept Radiol, Wuhan, Peoples R China
[12] Zhengzhou Univ, Affiliated Canc Hosp, Dept Radiol, Zhengzhou, Peoples R China
[13] Henan Canc Hosp, Zhengzhou, Peoples R China
[14] Kunming Med Univ, Affiliated Hosp 3, Yunnan Canc Hosp, Yunnan Canc Ctr,Dept Pathol, Kunming, Yunnan, Peoples R China
[15] Kunming Med Univ, Affiliated Hosp 3, Yunnan Canc Hosp, Yunnan Canc Ctr,Dept Cadres Med Oncol, Kunming, Yunnan, Peoples R China
[16] Catholic Univ Louvain, Clin Univ St Luc, Dept Internal Med, Brussels, Belgium
[17] Catholic Univ Louvain, Clin Univ St Luc, Dept Pneumol, Brussels, Belgium
[18] Catholic Univ Louvain, Clin Univ St Luc, Dept Radiol, Brussels, Belgium
[19] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Canc Ctr, Dept Breast Canc, Guangzhou, Peoples R China
[20] Southern Med Univ, Sch Clin Med 2, Guangzhou, Peoples R China
[21] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Prov Key Lab Artificial Intelligence Me, Guangzhou, Peoples R China
关键词
Non-small cell lung cancer; Immunohistochemistry; Ecosystem; Prognosis; Computed tomography; PD-1; BLOCKADE; EVOLUTIONARY; IMMUNOSCORE;
D O I
10.1007/s00330-022-08873-6
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objectives To date, there are no data on the noninvasive surrogate of intratumoural immune status that could be prognostic of survival outcomes in non-small cell lung cancer (NSCLC). We aimed to develop and validate the immune ecosystem diversity index (iEDI), an imaging biomarker, to indicate the intratumoural immune status in NSCLC. We further investigated the clinical relevance of the biomarker for survival prediction. Methods In this retrospective study, two independent NSCLC cohorts (Resec1, n = 149; Resec2, n = 97) were included to develop and validate the iEDI to classify the intratumoural immune status. Paraffin-embedded resected specimens in Resec1 and Resec2 were stained by immunohistochemistry, and the density percentiles of CD3(+), CD4(+), and CD8(+) T cells to all cells were quantified to estimate intratumoural immune status. Then, EDI features were extracted using preoperative computed tomography to develop an imaging biomarker, called iEDI, to determine the immune status. The prognostic value of iEDI was investigated on NSCLC patients receiving surgical resection (Resec1; Resec2; internal cohort Resec3, n = 419; external cohort Resec4, n = 96; and TCIA cohort Resec5, n = 55). Results iEDI successfully classified immune status in Resec1 (AUC 0.771, 95% confidence interval [CI] 0.759-0.783; and 0.770 through internal validation) and Resec2 (0.669, 0.647-0.691). Patients with higher iEDI-score had longer overall survival (OS) in Resec3 (unadjusted hazard ratio 0.335, 95%CI 0.206-0.546, p < 0.001), Resec4 (0.199, 0.040-1.000, p < 0.001), and TCIA (0.303, 0.098-0.944, p = 0.001). Conclusions iEDI is a non-invasive surrogate of intratumoural immune status and prognostic of OS for NSCLC patients receiving surgical resection.
引用
收藏
页码:8726 / 8736
页数:11
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