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Analysis of the Correlation and Prognostic Significance of Tertiary Lymphoid Structures in Breast Cancer: A Radiomics-Clinical Integration Approach

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机构: [1]Univ Elect Sci & Technol China, Canc Hosp, Sichuan Canc Ctr, Dept Radiat Oncol,Sichuan Clin Res Ctr Canc,Sichua, Chengdu, Peoples R China [2]Southwest Med Univ, Sch Clin Med, Dept Oncol, Luzhou, Peoples R China [3]Key Lab Sichuan Prov, Radiat Oncol, Chengdu, Peoples R China [4]Univ Elect Sci & Technol China, Canc Hosp, Sichuan Canc Ctr, Dept Pathol,Sichuan Clin Res Ctr Canc,Sichuan Canc, Chengdu, Peoples R China [5]Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sch Med, Chengdu, Peoples R China [6]Meishan Canc Hosp, Dept Chest, Meishan, Peoples R China [7]Chengdu Womens & Childrens Hosp, Dept Breast Surg, Chengdu, Peoples R China
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关键词: tertiary lymphoid structures breast cancer radiomics prognosis clinical pathology

摘要:
Background: Tertiary lymphoid structures (TLSs) are potential prognostic indicators. Radiomics may help reduce unnecessary invasive operations. Purpose: To analyze the association between TLSs and prognosis, and to establish a nomogram model to evaluate the expression of TLSs in breast cancer (BC) patients. Study Type: Retrospective. Population: Two hundred forty-two patients with localized primary BC (confirmed by surgery) were divided into BC + TLS group (N = 122) and BC - TLS group (N = 120). Field Strength/Sequence: 3.0T; Caipirinha-Dixon-TWIST-volume interpolated breath-hold sequence for dynamic contrastenhanced (DCE) MRI and inversion-recovery turbo spin echo sequence for T2-weighted imaging (T2WI). Assessment: Three models for differentiating BC + TLS and BC - TLS were developed: 1) a clinical model, 2) a radiomics signature model, and 3) a combined clinical and radiomics (nomogram) model. The overall survival (OS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were compared to evaluate the prognostic value of TLSs. Statistical Tests: LASSO algorithm and ANOVA were used to select highly correlated features. Clinical relevant variables were identified by multivariable logistic regression. Model performance was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC), and through decision curve analysis (DCA). The Kaplan-Meier method was used to calculate the survival rate. Results: The radiomics signature model (training: AUC 0.766; test: AUC 0.749) and the nomogram model (training: AUC 0.820; test: AUC 0.749) showed better validation performance than the clinical model. DCA showed that the nomogram model had a higher net benefit than the other models. The median follow-up time was 52 months. While there was no significant difference in 3-year OS (P = 0.22) between BC + TLS and BC - TLS patients, there were significant differences in 3-year DFS and 3-year DMFS between the two groups. Data Conclusion: The nomogram model performs well in distinguishing the presence or absence of TLS. BC + TLS patients had higher long-term disease control rates and better prognoses than those without TLS.

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基金编号: 2022NSFSC0051 YB2022003 2021YF0501659SN

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 核医学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 核医学
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出版当年[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

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第一作者机构: [1]Univ Elect Sci & Technol China, Canc Hosp, Sichuan Canc Ctr, Dept Radiat Oncol,Sichuan Clin Res Ctr Canc,Sichua, Chengdu, Peoples R China [2]Southwest Med Univ, Sch Clin Med, Dept Oncol, Luzhou, Peoples R China [3]Key Lab Sichuan Prov, Radiat Oncol, Chengdu, Peoples R China
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通讯机构: [1]Univ Elect Sci & Technol China, Canc Hosp, Sichuan Canc Ctr, Dept Radiat Oncol,Sichuan Clin Res Ctr Canc,Sichua, Chengdu, Peoples R China [2]Southwest Med Univ, Sch Clin Med, Dept Oncol, Luzhou, Peoples R China [3]Key Lab Sichuan Prov, Radiat Oncol, Chengdu, Peoples R China [5]Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sch Med, Chengdu, Peoples R China
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