肝细胞癌肝内早期复发转移CT预测模型初步建立与应用  

An initial design and application of CT imaging prediction model on early interhepatic recurrence and metastasis of hepatocellular carcinoma

作　　者：高顺禹[1,2] 张晓鹏[1,2] 崔湧[1,2] 孙应实[1,2] 唐磊[1,2] 单军[1,2] 李晓婷[1,2] 

机构地区：[1]北京大学肿瘤医院 [2]北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国医学影像技术》2014年第5期762-766,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81371715);国家重点基础研究发展计划(973计划)项目(2011CB707705);北京市科学技术委员会:首都特色临床应用研究(Z121107001012115)

摘　　要：目的初步建立肝细胞癌(HCC)肝内早期复发转移CT预测模型。方法收集175例经病理证实的HCC的治疗前多期增强CT资料,随机分为建模样本(n=115)和验证样本(n=60)。建模样本用于单因素及多因素分析,以寻找与HCC早期肝内复发转移相关的CT影响因素;根据多因素分析结果及其权重系数,对各因素赋值计分,建立HCC肝内早期复发CT预测评分系统,确定诊断界值。验证样本用于计算CT评分系统预测HCC肝内早期复发转移的准确率、敏感度、特异度。结果根据Logistic回归多因素分析结果,对病灶≥6.0cm、有子灶、伴有血管侵犯、包膜不完整或无包膜4项与HCC肝内早期复发转移相关的CT指标分别赋值,各计1分,建立CT评分系统。预测HCC肝内早期复发转移ROC曲线下面积为0.808,CT评分≥2分为CT预测HCC肝内早期复发转移诊断界值。验证样本预测HCC肝内早期复发转移的准确率为78.26%(90/115),敏感度为89.39%(59/66),特异度为63.27%(31/49)。结论此CT评分系统可用于预测HCC肝内早期复发转移。Objective To establish a CT imaging prediction model on early intrahepatic recurrence and metastasis of hepatocellular carcinoma （HCC）. Methods Pretreatment enhanced CT image data of 175 patients with pathologically confirmed HCC were retrospectively collected. The patients were randomly divided into modeling sample group （n=115） and validation sample group （n=60）. Modeling samples were used for univariate and multivariate analysis to identify factors in CT imaging related with early intrahepatic recurrence and metastasis of HCC. According to multivariate analysis results and the weighting coefficient, the factors were assigned scores, then a CT imaging prediction system of early intrahepatic recurrence and metastasis of HCC was established. The validation samples were used to compute the accuracy, sensitivity and specificity of this CT imaging prediction system. Results According to the results of Logistic regression analysis, determinant factors including lesion size ≥6.0 cm, with satellite nodule, associated with vascular invasion, capsule incomplete or no capsule, were assigned 1 score, respectively. The area under ROC curve for prediction of early intrahepatic recurrence and metastasis of HCC was 0. 808. Taking 2 scores as the cutoff value, the accuracy of prediction early recurrence of liver cancer and metastases was 78.26% （90/115）, sensitivity was 89.39% （59/66）, and specificity was 63.27% （31/49）. Conclusion The established CT imaging score model can be used to predict early intrahepatic recurrence and metastasis of HCC.

关 键 词：癌 肝细胞 体层摄影术 X线计算机 复发 肿瘤转移 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]