Background: Texture analysis (TA) has shown promise in characterizing intratumoral heterogeneity from imaging data. We add to the literature that shows its capability to differentiate oropharyngeal cancers based on HPV status. Methods: Multislice CT analysis was done in 120 patients with confirmed OP SCC: a single 5 mm region of interest was placed on three consecutive homogeneous CT slices per patient. Texture features were extracted by using gray-level co-occurrence matrices averaged per patient. HPV status (via p16 IHC and molecular confirmation) and differentiation grade (i.e., good, moderate, and poor) were recorded. Non-parametric statistical tests assessed differences between subgroups. Results: Seven texture parameters (i.e., angular second moment, contrast, sum of squares, sum entropy, entropy, inverse difference moment, and difference variance) differed significantly between HPV+ and HPV− tumors (allp< 0.05). HPV+ tumors exhibited increased heterogeneity and complexity on CT imaging. No texture feature correlated with histological grade. Conclusions: This study adds to the growing evidence that CT-based TA can assess HPV status in OP SCC. TA may be promising, though it requires further validation as an adjunctive method integrating into radiomics workflows to develop predictive models for diagnosis, prognosis, and treatment planning.
背景：纹理分析（TA）在通过影像数据表征肿瘤内异质性方面展现出潜力。本研究进一步证实了其基于HPV状态区分口咽癌的能力。方法：对120例确诊为口咽鳞状细胞癌（OP SCC）患者进行多层CT分析：每位患者在连续三个均匀CT层面各选取一个5mm的感兴趣区域。通过计算每位患者灰度共生矩阵的平均值提取纹理特征。记录HPV状态（经p16免疫组化及分子检测确认）及分化程度（良好、中等、差）。采用非参数统计检验评估亚组间差异。结果：七项纹理参数（角二阶矩、对比度、平方和、和熵、熵、逆差矩、差方差）在HPV阳性与HPV阴性肿瘤间存在显著差异（所有p<0.05）。HPV阳性肿瘤在CT影像上表现出更高的异质性和复杂性。未发现纹理特征与组织学分级存在相关性。结论：本研究进一步证明基于CT的纹理分析能够评估口咽鳞状细胞癌的HPV状态。纹理分析作为影像组学工作流程的辅助方法，在构建诊断、预后及治疗规划的预测模型方面具有潜力，但仍需进一步验证。
肿瘤(癌症)患者之家