PDF(Pubmed)
Abstract：
Forkhead box P3 (FOXP3) has been identified as a novel molecular marker in various types of cancer. The present study assessed the expression of FOXP3 in patients with head and neck squamous cell carcinoma (HNSCC) and its potential as a clinical prognostic indicator, and developed a radiomics model based on enhanced computed tomography (CT) imaging. Data from 483 patients with HNSCC were downloaded from the Cancer Genome Atlas for FOXP3 prognostic analysis and enhanced CT images from 139 patients included in the Cancer Imaging Archives, which were subjected to the maximum relevance and minimum redundancy and recursive feature elimination algorithms for radiomics feature extraction and processing. Logistic regression was used to build a model for predicting FOXP3 expression. A prognostic scoring system for radiomics score (RS), FOXP3, and patient clinicopathological factors was established to predict patient survival. The area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve and decision curve analysis (DCA) were used to evaluate model performance. Furthermore, the relationship between FOXP3 and the immune microenvironment, as well as the association between RS and immune checkpoint-related genes, was analyzed. Results of analysis revealed that patients with HNSCC and high FOXP3 mRNA expression exhibited better overall survival. Immune infiltration analysis revealed that FOXP3 had a positive correlation with CD4 + and CD8 + T cells and other immune cells. The 8 best radiomics features were selected to construct the radiomics model. In the FOXP3 expression prediction model, the AUC values were 0.707 and 0.702 for the training and validation sets, respectively. Additionally, the calibration curve and DCA demonstrated the positive diagnostic utility of the model. RS was correlated with immune checkpoint-related genes such as ICOS, CTLA4, and PDCD1. A predictive nomogram was established, the AUCs were 0.87, 0.787, and 0.801 at 12, 24, and 36 months, respectively, and DCA demonstrated the high clinical applicability of the nomogram. The enhanced CT radiomics model can predict expression of FOXP3 and prognosis in patients with HNSCC. As such, FOXP3 may be used as a novel prognostic marker to improve individualized clinical diagnosis and treatment decisions.
摘要：
叉头盒P3(FOXP3)已被鉴定为各种类型癌症中的新型分子标志物。本研究评估了FOXP3在头颈部鳞状细胞癌（HNSCC）患者中的表达及其作为临床预后指标的潜力。并开发了基于增强计算机断层扫描（CT）成像的影像组学模型。从癌症基因组图谱中下载了483例HNSCC患者的数据，用于FOXP3预后分析，并增强了来自癌症成像档案中139例患者的CT图像。进行了最大相关性和最小冗余以及递归特征消除算法，以进行影像组学特征提取和处理。采用Logistic回归建立FOXP3表达预测模型。影像组学评分（RS）的预后评分系统，FOXP3，并建立患者临床病理因素来预测患者的生存率。使用接收器工作特征（ROC）曲线（AUC）和校准曲线和决策曲线分析（DCA）下面积评估模型性能。此外，FOXP3与免疫微环境的关系，以及RS和免疫检查点相关基因之间的关联，被分析。分析结果表明，HNSCC和高FOXP3mRNA表达的患者表现出更好的总体生存率。免疫浸润分析显示FOXP3与CD4+、CD8+T细胞等免疫细胞呈正相关。选择8个最佳的影像组学特征来构建影像组学模型。在FOXP3表达预测模型中，训练集和验证集的AUC值为0.707和0.702，分别。此外,校准曲线和DCA证明了该模型的阳性诊断实用性。RS与免疫检查点相关基因如ICOS，CTLA4和PDCD1。建立了预测列线图，在12、24和36个月时，AUC分别为0.87、0.787和0.801，分别,和DCA证明了列线图的高度临床适用性。增强的CT影像组学模型可以预测HNSCC患者FOXP3的表达和预后。因此，FOXP3可作为一种新的预后标志物来改善个体化的临床诊断和治疗决策。
