Radiomics using computed tomography to predict CD73 expression and prognosis of colorectal cancer liver metastases

ABSTRACT: Background Finding a noninvasive radiomic surrogate of tumor immune features could help identify patients more likely to respond to novel immune checkpoint inhibitors. Particularly, CD73 is an ectonucleotidase that cata- lyzes the breakdown of extracellular AMP into immunosuppressive adenosine, which can be blocked by therapeutic antibodies. High CD73 expression in colorectal cancer liver metastasis (CRLM) resected with curative intent is associ- ated with early recurrence and shorter patient survival. The aim of this study was hence to evaluate whether machine learning analysis of preoperative liver CT-scan could estimate high vs low CD73 expression in CRLM and whether such radiomic score would have a prognostic significance. Methods We trained an Attentive Interpretable Tabular Learning (TabNet) model to predict, from preoperative CT images, stratified expression levels of CD73 (CD73High vs. CD73Low ) assessed by immunofluorescence (IF) on tissue microarrays. Radiomic features were extracted from 160 segmented CRLM of 122 patients with matched IF data, preprocessed and used to train the predictive model. We applied a five-fold cross-validation and validated the perfor- mance on a hold-out test set. Results TabNet provided areas under the receiver operating characteristic curve of 0.95 (95% CI 0.87 to 1.0) and 0.79 (0.65 to 0.92) on the training and hold-out test sets respectively, and outperformed other machine learning models. The TabNet-derived score, termed rad-CD73, was positively correlated with CD73 histological expression in matched CRLM (Spearman’s ρ = 0.6004; P < 0.0001). The median time to recurrence (TTR) and disease-specific survival (DSS) after CRLM resection in rad-CD73High vs rad-CD73 Low patients was 13.0 vs 23.6 months (P = 0.0098) and 53.4 vs 126.0 months (P = 0.0222), respectively. The prognostic value of rad-CD73 was independent of the standard clinical risk score, for both TTR (HR = 2.11, 95% CI 1.30 to 3.45, P < 0.005) and DSS (HR = 1.88, 95% CI 1.11 to 3.18, P = 0.020)

Assault induced stab injuries : epidemiology and actual treatment strategy

If the crime of gambling is left in the City of Bukittinggi and the City of Payakumbuh, then it is not impossible that this future will be bleak because of the mentality of the Indonesian people, especially the younger generation will be dilapidated, even all their behavior will tend to commit crime. The formulation of the problem in this study is whether the causes of gambling crime in the jurisdiction of Bukittinggi District Police and Payakumbuh City Police ?, Are the obstacles in countering the crime of gambling by the Bukittinggi Police investigator and Payakumbuh Police investigator? and the Payakumbuh Police investigator ?, the method used in this research is empirical juridical. The results showed that the causes of gambling crime in the Legal Area of Bukittinggi City Police and Payakumbuh were not only those who belonged to the "haves" group, but from the people who lacked economic conditions, lack of public understanding of religious teachings, and environmental conditions. get used to or at least invite the public to do gambling. Secondly, the obstacles encountered in countering gambling crime by the Bukittinggi City Police investigator and Payakumbuh City are limited by law enforcement officers, especially investigators, lack of facilities and infrastructure in operational costs, non-permanent gambling, some people do not want to be witnesses, lack of awareness the community and the involvement of police officers who became back-up gambling. Third, efforts to tackle the crime of gambling by the Bukittinggi City Police investigator and Payakumbuh City are carried out in a preventive and repressive manner

Intrapulmonary glomus tumor in a young woman

www.icvts.or