An interpretable machine learning model based on computed tomography radiomics for predicting programmed death ligand 1 expression status in gastric cancer

作者：Lihuan Dai, Jinxue Yin, Xin Xin, Chun Yao, Yongfang Tang, Xiaohong Xia, Yuanlin Chen, Shuying Lai, Guo‐Liang Lu, Jie Huang, Purong Zhang, Jiansheng Li, Xiangguang Chen, Xi Zhong · 发表于：Cancer Imaging · 年份：2025 · DOI：10.1186/s40644-025-00855-3 · 被引用次数：11 · 研究领域：Radiomics and Machine Learning in Medical Imaging、Cancer Immunotherapy and Biomarkers、Gastric Cancer Management and Outcomes

BACKGROUND: Programmed death ligand 1 (PD-L1) expression status, closely related to immunotherapy outcomes, is a reliable biomarker for screening patients who may benefit from immunotherapy. Here, we developed and validated an interpretable machine learning (ML) model based on contrast-enhanced computed tomography (CECT) radiomics for preoperatively predicting PD-L1 expression status in patients with gastric cancer (GC). METHODS: We retrospectively recruited 285 GC patients who underwent CECT and PD-L1 detection from two medical centers. A PD-L1 combined positive score (CPS) of ≥ 5 was considered to indicate a high PD-L1 expression status. Patients from center 1 were divided into training (n = 143) and validation sets (n = 62), and patients from center 2 were considered a test set (n = 80). Radiomics features were extracted from venous-phase CT images. After feature reduction and selection, 11 ML algorithms were employed to develop predictive models, and their performance in predicting PD-L1 expression status was evaluated using areas under receiver operating characteristic curves (AUCs). SHapley Additive exPlanations (SHAP) were used to interpret the optimal model and visualize the decision-making process for a single individual. RESULTS: Nine features significantly associated with PD-L1 expression status were ultimately selected to construct the predictive model. The light gradient-boosting machine (LGBM) model demonstrated the best performance for PD-L1 high expression sta...