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基于MRI的MIBC无监督聚类揭示了瘤内异质性表型和新辅助化疗疗效率

Yuheng Zhang¹, Lingkai Cai^1,2, Yuhan Chen¹

¹Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Cancer imaging : the official publication of the International Cancer Imaging Society

|February 26, 2026

概括

一个新的基于MRI的瘤内部异质性 (IITH) 框架准确地预测了肌肉侵入性膀癌 (MIBC) 患者的结果. 高IITH与更差的生存率和侵略性瘤生物学有关,有助于风险分层.

科学领域:

在瘤学瘤学.
放射学放射学是一门学科.
基因组学就是基因组学.

背景情况:

肌肉侵入性膀癌 (MIBC) 需要准确的风险分层来进行有效的治疗.
瘤内部异质性 (IITH) 是影响癌症进展和治疗反应的关键因素.
需要使用非侵入性成像方法来评估IITH.

研究的目的:

开发和验证一种基于MRI的非侵入性IITH框架,用于MIBC的风险分层.
评估IITH框架与生存结果的关联.
为了研究IITH和MIBC中的分子亚型之间的关系.

主要方法:

在发现,验证和新辅助化疗 (NAC) 队列中对437名MIBC患者进行了回顾性分析.
从预处理MRI扫描中提取42个放射性特征.
无监督的共识聚类以确定稳定的IITH亚型.
对总生存 (OS),癌症特定生存 (CSS),无复发生存 (RFS) 和无进展生存 (PFS) 的预后意义进行了评估.
使用免疫组织化学和癌症基因组图谱 (TCGA) 转录组数据评估的分子相关性.

主要成果:

IITH框架在OS,CSS,RFS和PFS的发现和验证队伍中显著分层生存.
高IITH瘤表现出更大的组织多样性和丰富的混合亚型.
在NAC队列中,高IITH与较差的CSS,RFS和PFS密切相关.
转录组分析显示,在高IITH组中,炎症活性升高和增强的增殖/迁移潜力.

结论:

基于MRI的IITH框架有效地分层MIBC患者的预后,并预测治疗反应.
在MIBC中,高的内异质性与不良结果和侵略性的分子瘤生物学有关.
这种基于成像的方法为MIBC的个性化风险评估提供了有价值的工具.

关键词:

膀癌是一种癌症.瘤内异质性的异质性这就是为什么MRI是MRI.新辅助化学疗法新辅助化学疗法预测值的预测值是指预测值的预测值.

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