影像组学联合CT特征对周围型肺腺癌及鳞癌的鉴别价值研究  

Diagnostic value of radiomics combined with CT features for differentiating peripheral lung adenocarcinoma from squamous cell carcinoma

作　　者：陆亮 徐圆 LU Liang;XU Yuan(Department of Radiology,Jianhu People's Hospital Affiliated to Nantong University,Yancheng 224700,Jiangsu Province,China;Department of Radiology,Yancheng First Hospital,Affiliated Hospital of Nanjing University Medical School,Yancheng First People's Hospital,Yancheng 224006,Jiangsu Province,China)

机构地区：[1]南通大学附属建湖人民医院影像科,江苏盐城224700 [2]南京大学医学院附属盐城第一医院影像科,盐城市第一人民医院影像科,江苏盐城224006

出　　处：《医疗卫生装备》2021年第10期48-52,63,共6页Chinese Medical Equipment Journal

摘　　要：目的:基于影像组学和CT形态学特征对周围型肺腺癌和鳞癌进行有效鉴别。方法:回顾性分析151例周围型肺癌患者的临床资料,其中腺癌组75例、鳞癌组76例。利用Mazda软件勾画感兴趣区,提取特征纹理参数。评估CT图像形态学特征,构建Logistic回归模型,将数据按7∶3的比例随机分为训练集及测试集,采用ROC曲线评估模型诊断效能,并绘制森林图与校准曲线。数据采用SPSS 22.0、Graphad Prism 7.0和R语言包等软件进行统计学分析。结果:周围型肺鳞癌多见于男性,且鳞癌组患者年龄及病灶直径均大于腺癌组;分叶征、实性结节多见于鳞癌组,胸膜牵拉征多见于腺癌组,以上差异均具有统计学意义(P均<0.05)。训练集及测试集的CT临床特征模型的AUC值分别为0.850、0.838,其对应的敏感度、特异度分别为92.0%、76.0%和89.0%、80.0%;训练集及测试集的影像组学联合CT特征模型的AUC值分别为0.879、0.869,其对应的敏感度、特异度分别为94.0%、90.0%和92.0%、89.0%。影像组学联合CT特征模型诊断效能稍高于CT临床特征模型。鳞癌组除了胸膜牵拉征这一变量为负相关危险因素,Perc.01%(01百分比值)、分叶征、病灶直径及性别均为正相关危险因素。内部验证的校准曲线亦显示影像组学联合CT特征模型具有较好的预测精度。结论:影像组学联合CT特征模型可较好地鉴别周围型肺鳞癌及腺癌,具有无创、低成本、可重复等优点,可为不可手术的晚期肺腺癌及鳞癌患者的临床诊断及个体化治疗提供帮助。Objective To differentiate peripheral lung adenocarcinoma from squamous cell carcinoma based on radiomics and CT morphological features.Methods The clinical data of 151 patients with peripheral lung adenocarcinoma were analyzed retrospectively,including 75 cases enrolled into an adenocarcinoma group and 76 cases into a squamous cell carcinoma group.Mazda software was used to outline the region of interest and extract the characteristic texture parameters.The CT morphological features were evaluated,logistic regression models were constructed,and the data were randomly divided into training and test sets in the ratio of 7∶3.The diagnostic efficacies of the models were assessed with ROC curves,and forest plots and calibration curves were drawn.The data were statistically analyzed using SPSS 22.0,Graphad Prism 7.0 and R language package.Results Peripheral squamous lung cancer was more common in male,and the patients in the squamous cell carcinoma group had older age and larger lesion diameter than those in the adenocarcinoma group;lobar signs and solid nodules occurred more frequently in the squamous cell carcinoma group,and pleural traction signs were found more often in the adenocarcinoma group,and all the above differences were statistically significant(P<0.05).The model established with CT features had the AUC values of the training and test sets being 0.850 and 0.838,respectively,and their corresponding sensitivities and speci-ficities were 92.0%,76.0%and 89.0%,80.0%,respectively;the model constructed with combined radiomics and CT features had the AUC values of the training and test sets being 0.879 and 0.869,respectively,and their corresponding sensitivities and specificities were 94.0%,90.0%and 92.0%,89.0%,respectively.The diagnostic efficacy of radiomics combined with CT features was slightly higher than that of CT features.In the squamous cell carcinoma group,Perc.01%(01 percentage value),lobar sign,lesion diameter and gender were all positively associated risk factors,except for the variable pleural tra

关 键 词：影像组学 周围型肺癌 腺癌 鳞癌 CT特征 

分 类 号：R318[医药卫生—生物医学工程] R445[医药卫生—基础医学]