超声征象Logistics回归鉴别睾丸精原细胞瘤和原发性睾丸淋巴瘤  

Logistic regression of ultrasound signs to differentiate testicular seminoma and primary testicular lymphoma

作　　者：曾小科 王学梅[1] 陈治光 桑亮[1] 李子怡 李莹 ZENG Xiao-ke;WANG Xue-mei;CHEN Zhi-guang;SANG Liang;LI Zi-yi;LI Ying(Department of Ultrasound,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院超声科,辽宁沈阳110001

出　　处：《中国临床医学影像杂志》2022年第3期197-200,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨睾丸病变的临床特点和超声征象在睾丸精原细胞瘤和原发性睾丸淋巴瘤中的鉴别诊断价值。方法:回顾性分析经手术病理证实的82例睾丸肿瘤患者的临床病例和超声声像图,根据病理结果分为精原细胞瘤组59例和原发性睾丸淋巴瘤组23例,就其临床特点和超声征象进行单因素分析,将超声征象中有统计学意义参数设为自变量进行Logistic回归分析。结果:单因素分析显示,患者年龄、病灶位置、隐睾病史、病灶形态、边界、回声类型、无回声、强回声和后方回声在鉴别精原细胞瘤和原发性睾丸淋巴瘤中差异均有统计学意义(P<0.05);多因素中肿瘤的形态、边界、强回声和后方回声是鉴别二者的独立因素,建立的回归方程为:Logistic(Y)=2.242+2.222X1-2.848X2-3.899X3-3.366X4(X1:形态;X2:边界;X3:强回声;X4:后方回声),ROC曲线下面积0.904,模型鉴别睾丸精原细胞瘤和原发性睾丸淋巴瘤的灵敏度、特异度和准确性分别是67.9%、96.6%、87.35%。结论:多因素分析在鉴别睾丸精原细胞瘤和原发性睾丸淋巴瘤中有较好的诊断效能,超声上肿瘤的形态、边界、强回声和后方回声可作为综合判断二者的可靠指标。Objective:To investigate the clinical characteristics and ultrasound signs of testicular lesions in the differential diagnosis of testicular seminoma and primary testicular lymphoma.Methods:A retrospective analysis was made on the clinical signs and ultrasound images of 82 patients with testicular tumors confirmed by surgery and pathology.According to the pathological results,they were divided into seminoma group(59 cases)and primary testicular lymphoma group(23 cases).The charac-teristics and ultrasound signs were analyzed by univariate analysis,and the statistically significant parameters in the ultrasound signs were set as independent variables for Logistic regression analysis.Results:The univariate analysis showed that the patient’s age,lesion location,cryptorchidism history,lesion morphology,boundary,echo type,anechoic,strong echo and posterior echo were different in distinguishing seminoma and primary testicular lymphoma with statistical significance(P<0.05).Among the multiple factors,tumor shape,border,strong echo and rear echo were independent factors which could distinguish the two.The regression equation was Logistic(Y)=2.242+2.222X1-2.848X2-3.899X3-3.366X4(X1:morphology;X2:boundary;X3:strong echo;X4:rear echo),and the area under the ROC curve was 0.904.The sensitivity,specificity and the accuracy of the model were 67.9%,96.6%and 87.35%respectively.Conclusion:Multivariate analysis has good diagnostic efficiency in differentiating testicular seminoma and primary testicular lymphoma.Tumor morphology,border,strong echo and posterior echo on ultrasound can be used as reliable indicators for comprehensive judgment of the two.

关 键 词：睾丸肿瘤 精原细胞瘤 淋巴瘤 超声检查 

分 类 号：R737.21[医药卫生—肿瘤] R733.4[医药卫生—临床医学]