ABSTRACT
Objective:To investigate the value of multimodal MRI radiomics in the preoperative prediction of Fuhrman nuclear grade of clear cell renal cell carcinoma (ccRCC).Methods:A total of 129 patients with ccRCC confirmed by pathology from April 2011 to April 2021 in Third Affiliated Hospital of Soochow University were collected, and the imaging and clinicopathological data were retrospectively analyzed. All patients were divided into training set ( n=90) and validation set ( n=39) at the ratio of 7∶3 using random indicator method. According to the postoperative pathological results, Fuhrman grades Ⅰ and Ⅱ were included in the low grade group (96 cases, 65 cases in the training set and 31 cases in the validation set), and Fuhrman grades Ⅲ and Ⅳ were included in the high grade group (33 cases, 25 cases in the training set and 8 cases in the validation set). Two radiologists manually delineated regions of interest (ROI) on T 1WI, T 2WI, Dixon-water, Dixon-fat, susceptibility weighted imaging (SWI), blood oxygen level dependent (BOLD) images, and 396 texture features were extracted from each ROI. In the training set, intra-class correlation coefficient, Mann-Whitney U test, minimum redundancy maximum relevance and least absolute shrinkage and selection operator method were used to reduce the dimension of features to obtain the best texture features. The logistic regression was used to develop the multimodal radiomics model, and the receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of the model in identifying high and low-grade ccRCC in training set and validation set. Results:Four SWI, one T 2WI and one BOLD texture features were selected for modeling. The areas under the ROC curve (95%CI) of the multimodal radiomics model for identifying high and low grade ccRCC in the training and validation sets were 0.859 (0.770-0.923) and 0.883 (0.740-0.964), with the specificity at 95.4% and 87.1%, the sensitivity at 68.0% and 87.5%, the accuracy at 87.8% and 87.2%, respectively. Conclusion:The multimodal MRI radiomics model based on T 2WI, SWI and BOLD images has high effectiveness in preoperative predicting Fuhrman nuclear grade of ccRCC.
ABSTRACT
Purpose To investigate the expression of EphA1 in renal cell carcinomas ( RCC) and to analyze its correlation with clini-copathological parameters in order to explore the clinical significance of EphA1 protein in renal cell carcinomas ( RCC) . Methods The immunocytochemical method was employed to measure the expression of EphA1 in 144 clear cell RCC ( ccRCC) tissues, 18 chro-mophobe RCC tissues and 6 papillary RCC tissues. Correlation between EphA1 protein expression and clinical parameters was evaluated by statistics. Results High level of the expression of EphA1 was observed in all normal renal tubes. The EphA1 protein was negative-ly or weakly expressed in 93 out of 144 ccRCC (64. 6%) and positively expressed in 51 out of 144 ccRCC (35. 4%). Positive expres-sion of EphA1 was observed in all samples of chromophobe RCC and papillary RCC. The high level expression of the EphA1 protein was significantly associated with younger patients (P<0. 001), sex (P=0. 016) and lower nuclear grade (P<0. 001). No significant relation between the expression of EphA1 and tumor diameter was found ( P=0. 316 ) . Conclusion EphA1 protein may be a new marker for the prognosis of ccRCC.