Prognostic value and molecular correlates of a CT image-based quantitative pleural contact index in early stage NSCLC.
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ABSTRACT: PURPOSE:To evaluate the prognostic value and molecular basis of a CT-derived pleural contact index (PCI) in early stage non-small cell lung cancer (NSCLC). EXPERIMENTAL DESIGN:We retrospectively analysed seven NSCLC cohorts. A quantitative PCI was defined on CT as the length of tumour-pleura interface normalised by tumour diameter. We evaluated the prognostic value of PCI in a discovery cohort (n?=?117) and tested in an external cohort (n?=?88) of stage I NSCLC. Additionally, we identified the molecular correlates and built a gene expression-based surrogate of PCI using another cohort of 89 patients. To further evaluate the prognostic relevance, we used four datasets totalling 775 stage I patients with publically available gene expression data and linked survival information. RESULTS:At a cutoff of 0.8, PCI stratified patients for overall survival in both imaging cohorts (log-rank p?=?0.0076, 0.0304). Extracellular matrix (ECM) remodelling was enriched among genes associated with PCI (p?=?0.0003). The genomic surrogate of PCI remained an independent predictor of overall survival in the gene expression cohorts (hazard ratio: 1.46, p?=?0.0007) adjusting for age, gender, and tumour stage. CONCLUSIONS:CT-derived pleural contact index is associated with ECM remodelling and may serve as a noninvasive prognostic marker in early stage NSCLC. KEY POINTS:• A quantitative pleural contact index (PCI) predicts survival in early stage NSCLC. • PCI is associated with extracellular matrix organisation and collagen catabolic process. • A multi-gene surrogate of PCI is an independent predictor of survival. • PCI can be used to noninvasively identify patients with poor prognosis.
SUBMITTER: Lee J
PROVIDER: S-EPMC5741526 | biostudies-literature | 2018 Feb
REPOSITORIES: biostudies-literature
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