Radiomics for predicting perineural invasion status in rectal cancer

doi:10.3748/wjg.v27.i33.5610

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Sep 7, 2021 (publication date) through Apr 15, 2025

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Sep 7, 2021; 27(33): 5610-5621
Published online Sep 7, 2021. doi: 10.3748/wjg.v27.i33.5610

Table 1 Baseline characteristics of the study population

Characteristics	PNI⁺ (n = 144)	PNI^-(n = 159)	P value	The training set(n = 242)	The validation set(n = 61)	P value
Age (mean ± SD, yr)	58.9 ± 11.8	58.9 ± 11.7	0.952	58.4 ± 11.9	60.8 ± 10.2	0.162
Sex (male/female)	77/67	93/66	0.379	140/102	30/31	0.223
Volume (cm³)	19.7	20.8	0.132	20.1	20.8	0.847
Location¹			0.075			0.045
Middle-low	101	96		164	33
High	43	63		78	28
cT stage (T1-2/T3/T4)	25/98/21	57/90/12	< 0.001	61/156/25	21/32/8	0.222
cN stage (N0/N1/N2)	31/52/61	75/59/25	< 0.001	89/84/69	17/27/17	0.313
Neoadjuvant therapy (+/-)	25/119	37/122	0.203	51/191	11/50	0.599
CEA (+/-) (positive ≥ 5 ng/mL)	77/67	56/103	0.001	107/135	26/35	0.823
CA19-9 (+/-) (positive ≥ 30 U/mL)	43/101	35/124	0.119	64/178	14/47	0.577
CA125 (+/-) (positive ≥ 24 U/mL)	20/124	15/144	0.226	20/222	3/58	0.378
pT stage (T1/T2/T3/T4)	0/15/117/12	8/44/95/12	< 0.001	6/48/171/17	2/11/41/7	0.584
pN stage (0/N1/N2)	29/74/41	81/56/22	< 0.001	88/101/53	22/29/10	0.579
Stage (Ⅰ/Ⅱ/Ⅲ)	10/28/115	38/43/78	< 0.001	40/48/154	8/14/39	0.731
Histologic grade (G1/G2/G3)	1/105/38	2/133/24	0.014	2/189/51	1/49/11	0.523
Rad-score	0.60 ± 0.19	0.40 ± 0.20	< 0.001	0.50±0.21	0.49 ± 0.23	0.805

¹Location: Low (0-5 cm from the anal verge), middle (5.1-10 cm from the anal verge), and high (10.1-15 cm from the anal verge). This table summarized the results of cT-stage and cN-stage for the two readers. CT: Computed tomography; PNI: Perineural invasion; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; CA125: Carbohydrate antigen 125; cT stage: Computed tomography-reported T stage; cN stage: Computed tomography-reported N stage; pT stage: Pathological T stage; pN stage: Pathological N stage.

Table 2 Risk factors selected by logistic regression analysis

Variables	Univariate		Multivariate
	OR	P value	OR	P value
Age	1.001	0.961	-	-
Sex	0.787	0.358	-	-
Volume	1.000	1.000	-	-
Location	1.779	0.050	1.470	0.265
cT stage	2.328	< 0.001	1.636	0.087
cN stage	1.550	< 0.001	1.458	0.001
CEA	2.631	< 0.001	2.528	0.003
CA19-9	1.478	0.182	-	-
CA125	0.717	0.484	-	-
Rad-score	3.012	< 0.001	3.148	< 0.001

If P value < 0.1, variables were included in the model. CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; CA125: Carbohydrate antigen 125; OR: Odds ratio.

Table 3 Comparisons of variables and models in the training and validation cohorts

	The training set				The validation set
	AUC	SEN (%)	SPE (%)	P value	AUC	SEN (%)	SPE (%)	P value
CEA	0.597 (0.533-0.660)	50.00	76.38	< 0.001	0.635 (0.502-0.754)	96.55	40.63	0.042
cT stage	0.613 (0.549-0.675)	84.35	33.86	< 0.001	0.589 (0.456-0.714)	75.86	43.75	0.004
cN stage	0.670 (0.607-0.729)	42.61	84.25	< 0.001	0.684 (0.553-0.797)	86.21	40.63	0.045
Rad-score	0.760 (0.701-0.812)	72.17	69.29	0.020	0.782 (0.658-0.878)	68.97	78.12	0.640
Clinical model	0.718 (0.657-0.774)	63.48	70.08	< 0.001	0.674 (0.542-0.789)	65.52	71.87	0.045
Combined model	0.828 (0.774-0.873)	66.09	88.19		0.801 (0.679-0.892)	62.07	93.75

P value: Compared with the combined model by DeLong’s test. AUC: Area under the receiver operating characteristic curve; SEN: Sensitivity; SPE: Specificity; CEA: Carcinoembryonic antigen.

Table 4 Subgroup analyses of the models in the whole cohort

	The clinical model			The combined model			P value
Subgroups	AUC	SEN (%)	SPE (%)	AUC	SEN (%)	SPE (%)
nCRT
With (n = 62)	0.710 (0.581-0.818)	68.00	75.68	0.853 (0.740-0.930)	68.00	89.19	0.011
Without (n = 241)	0.712 (0.650-0.768)	48.74	83.61	0.814 (0.759-0.861)	65.55	87.70	< 0.001
Stage
II (n = 62)	0.553 (0.422-0.680)	21.05	93.02	0.670 (0.538-0.784)	36.84	100.00	0.098
III (n = 193)	0.630 (0.558-0.698)	56.52	69.23	0.796 (0.732-0.851)	73.04	79.49	< 0.001

P value: Comparisons between the clinical model and combined model. AUC: Area under the receiver operating characteristic curve; SEN: Sensitivity; SPE: Specificity; nCRT: Neoadjuvant chemoradiotherapy.

Citation: Li M, Jin YM, Zhang YC, Zhao YL, Huang CC, Liu SM, Song B. Radiomics for predicting perineural invasion status in rectal cancer. World J Gastroenterol 2021; 27(33): 5610-5621
URL: https://www.wjgnet.com/1007-9327/full/v27/i33/5610.htm
DOI: https://dx.doi.org/10.3748/wjg.v27.i33.5610