头颈部鳞癌颈部淋巴结转移放疗残留灶超声特征的logistic回归模型分析  

Analysis on Logistic regression model of ultrasonographic features of neck lymph node metastasis residual lesions after radiotherapy in head and neck squamous cell carcinoma

作　　者：李龙浩[1] 蒋娟[1] 谭本旭[1] 余敏[1] 

机构地区：[1]重庆医科大学附属第一医院肿瘤科,重庆400016

出　　处：《现代医药卫生》2016年第12期1789-1791,共3页Journal of Modern Medicine & Health

基　　金：重庆市科技计划项目(20150400z)

摘　　要：目的探讨头颈部鳞癌颈部淋巴结转移放疗残留灶的超声影像学特征。方法回顾性分析2010年1月至2013年12月该院放疗后行颈淋巴结清扫术的76例患者病理检查结果与超声影像学特征的关系。对超声检查残留淋巴结纵/横径比、血流分级、供血动脉峰值流速、阻力指数值及消退速率与病理检查结果进行二元logistics回归模型分析。选取与病理检查结果具有一致性的指标进行受试者工作特征曲线分析得到临界值计算超声检查准确率,并比较与磁共振成像(MRI)检查的差异。结果 76例患者经颈淋巴结清扫术后病理检查阳性48例,阴性28例。仅有残留淋巴结供血动脉峰值流速及消退速率与病理检查结果具有一致性,用受试者工作特征曲线分析得到临界值的诊断准确率(分别为89.58、95.83%)均高于MRI(72.92%),差异均有统计学意义(P<0.05)。结论颈部超声检查可很好地评估头颈部鳞癌颈部淋巴结转移放疗残留灶的疗效,可及早发现残留灶,并指导后续治疗。Objective To investigate the ultrasonographic imaging features of neck lymph node metastasis residual le-sions after radiotherapy in head and neck squamous cell carcinoma. Methods The relation between the pathological examination results and ultrasound imaging features in 76 patients with neck lymph nodes dissection after radiotherapy in our hospital from January 2010 to December 2013 were retrospectively analyzed. The vertical diameter/transverse diameter ratio of residual lymph nodes,blood stream grade,blood supply artery peak flow velocity,resistance index value,subside speed and pathological examination results were performed the binary Logistic regression model analysis. The indexes of consistency with the pathological ex-amination results were selected for conducting the receiver operation characteristic（ROC） curve analysis. Then the critical value was obtained for calculating the ultrasonic examination accuracy,the differences between ultrasonic examination and MRI were compared. Results Among 76 cases of neck lymph nodes dissection,48 cases were positive in the pathological examination results,while 28 cases were negative. Only the blood supply artery peak flow velocity of residual lymph nodes and subside speed had consistency with the pathological examination results. The accuracy of critical value obtained by ROC curve was 89.58% and95.38% respectively, which were higher than 72.9% in MRI. Conclusion Cervical ultrasound examination could better evaluate the effect of neck lymph node metastasis residual lesions after radiotherapy in head and neck squamous cell carcinoma,can find the residual lesions as early as possible and guides the sequential treatment.

关 键 词：癌 鳞状细胞 头颈部肿瘤 淋巴转移/放射疗法 超声检查 磁共振成像 

分 类 号：R739.8[医药卫生—肿瘤]