新医学2025，Vol.56Issue(7)：645-653,9.DOI:10.12464/j.issn.0253-9802.2025-0023
超声影像组学特征联合miRNA-34a表达水平对乳腺癌新辅助化疗患者病理完全缓解的预测能力
Predictive ability of ultrasound radiomics features combined with miRNA-34a expression levels for pathological complete response in breast cancer patients receiving neoadjuvant chemotherapy
摘要
Abstract
Objective To investigate the predictive ability of ultrasound radiomics features combined with peripheral blood miRNA-34a expression levels for pathological complete response(pCR)in breast cancer patients receiving neoadjuvant chemotherapy(NAC).Methods A retrospective analysis was conducted on 93 breast cancer female patients diagnosed with breast cancer and treated with NAC from January 2019 to December 2023.Among them,53 patients were from the Sixth People's Hospital of Shanghai,and 40 patients were from Dongguan Binhaiwan Central Hospital.The expression level of miRNA-34a in peripheral blood was detected using real-time fluorescence quantitative reverse transcription polymerase chain reaction(qRT-PCR).107 radiomics features were extracted from preoperative ultrasound images using Pyradiomics software.After Spearman rank correlation test,Z-score normalization and LASSO regression analysis,five key radiomics features were selected.Clinical models based on miRNA-34a,ultrasound radiomics models based on radiomics features,and a combined model integrating both were constructed.The diagnostic performance was evaluated using the K-nearest neighbor(KNN)classifier.Results Univariate analysis showed that the expression levels of miRNA-34a in the pCR group were higher than those in the Non-pCR group(P<0.001).Multivariate Logistic analysis revealed that elevated miRNA-34a expression was an independent risk factor for pCR in breast cancer patients receiving NAC(P=0.015).The clinical model showed an AUC of 0.787(95%CI 0.547-1.000)in the training group and 0.764(95%CI 0.640-0.888)in the validation group.The ultrasound radiomics model showed an AUC of 0.806(95%CI 0.605-1.000)in the training group and 0.806(95%CI 0.711-0.901)in the validation group.The combined model significantly improved the AUC to 0.875(95%CI 0.712-1.000)in the training group and 0.875(95%CI 0.792-0.959)in the validation group.DeLong test results showed that the performance of the combined model was superior to the clinical model(P=0.015).Decision curve analysis further confirmed the clinical utility of the combined model.Conclusions The combined model significantly improves the predictive ability for pCR after NAC in breast cancer patients through integrating miRNA-34a expression levels and ultrasound radiomics features.The potential biological associations were observed between ultrasound radiomics features and molecular markers,providing new tools and theoretical support for personalized treatment.关键词
乳腺癌/miRNA-34a/新辅助化疗/病理完全缓解/超声影像组学/联合模型Key words
Breast cancer/miRNA-34a/Neoadjuvant chemotherapy/Pathologic complete response/Ultrasound radiomics/Combined model引用本文复制引用
张伟娜,钟李长,师琳,来金玉,陈杰桓,谷丽萍..超声影像组学特征联合miRNA-34a表达水平对乳腺癌新辅助化疗患者病理完全缓解的预测能力[J].新医学,2025,56(7):645-653,9.基金项目
上海市浦东新区科技发展基金事业单位民生科研专项(医疗卫生)(PKJ2020-Y09) （医疗卫生）
东莞市滨海湾中心医院院内科研项目(2021001) （2021001）
