超声评估涎腺肿块性质的初步研究  

Preliminary Study of Malignant Risk Assessment of Salivary Gland Mass by Ultrasound

作　　者：陈静[1] 陈琴[2] 邓椀月 周青[2] 吴昊[2] Chen Jing;Chen Qin;Deng Wanyue;Zhou Qing;Wu Hao(North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Ultrasound.Sichuan Provincial People’s Hospital,Chengdu,Sichuan 610072,China)

机构地区：[1]川北医学院,四川省南充市637000 [2]四川省人民医院超声科,成都市610072

出　　处：《中国超声医学杂志》2021年第8期855-858,共4页Chinese Journal of Ultrasound in Medicine

基　　金：四川省科技厅重点研发计划(重大科技专项)项目(No.2019YFS0442)。

摘　　要：目的根据超声图像特征建立涎腺肿块的良恶性预测模型,并评估其预测诊断价值。方法回顾性分析经病理证实的涎腺肿块病例696例,共713个肿块,进行单因素及多因素回归分析,建立预测模型。结果单因素及多因素回归分析建立的预测模型为:Logit(Y)=0.027×年龄+包膜(2.056×包膜不完整/2.943×无包膜)+颈部淋巴结(2.793×单个同侧淋巴结转移/0.888×多个同侧或双侧转移/-0.887×淋巴结反应性增生)+(1.326×边界成角+3.157×边界毛刺)-4.331,其中Y值肿块为恶性的预测值。该模型的最佳截断点为Y>0.224(即判断为恶性),曲线下面积AUC为0.858(0.830~0.883),预测灵敏度为72.0%(63.0%~79.9%),特异度为92.4%(90.0%~94.4%),约登指数为0.645。结论涎腺肿块的良恶性预测模型在鉴别良恶性肿块中具有较高的诊断价值,但还需进一步完善。Objective To establish the benign and malignant prediction model and evaluate its diagnostic value according to the ultrasonographic features of salivary gland mass. Methods 713 salivary gland masses in 696 cases confirmed by pathology were analyzed retrospectively. Univariate analysis and multivariate regression analysis were performed to establish the prediction model. Results By univariate and multivariate regression analysis, the prediction model was Logit(Y)=0.027× age+capsule(2.056× incomplete capsule/2.943×no capsule) + cervical lymph nodes(2.793×single ipsilateral lymph node metastases/0.888×multiple ipsilateral or bilateral metastases/-0.887×lymph node reactivity hyperplasia)+1.326×boundary angulation+3.157×boundary burr-4.331, where Y value was the predictive value of malignancy. The optimal cut-off point of this model was the predicted value Y>0.233(that is, it was judged to be malignant), the area under the curve AUC was 0.858(0.830-0.883), the predictive sensitivity was 72.0%(63.0%-79.9%), the specificity was 92.4%(90.0%-94.4%), and the Youden index was 0.645. Conclusions The prediction model of salivary gland mass has a considerable value in differentiating of benign and malignant, but needs to be further improved.

关 键 词：涎腺肿块 良恶性 超声 预测模型 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.87[医药卫生—诊断学]