基于CT影像组学对T1期肺腺癌淋巴结转移有较高的预测价值  

Prediction value of CT-based radiomics in lymph node metastasis of T1 lung adenocarcinoma

作　　者：欧阳振 于利智 张妹 孔令梅[2] OUYANG Zhen;YU Lizhi;ZHANG Mei;KONG Lingmei(Department of Radiology,Taian Municipal hospital,Taian 271600,China;Department of Radiology,the Second Affiliated Hospital of Medi-cal College of Shantou University,Shantou 515021,China)

机构地区：[1]泰安市立医院放射科,山东泰安271600 [2]汕头大学医学院第二附属医院放射科,广东汕头515021

出　　处：《分子影像学杂志》2022年第3期339-343,共5页Journal of Molecular Imaging

基　　金：广东省医学科研基金(B2021204)。

摘　　要：目的 分析CT影像组学对T1期肺腺癌淋巴结转移状态的预测价值。方法 回顾性选择2016年6月~2019年5月我院收治的肺腺癌患者140例,以术中送检的病理组织标本检查结果为金标准,分为金标准阳性组67例与金标准阴性组73例。分别采用术前增强CT、术前CT影像组学评估两组淋巴结转移发生情况。利用Delong检验评估CT影像组学与增强CT在两组中预测对淋巴结转移的价值。结果 CT影像组学法对阳性淋巴结转移的预测比率为86.57%(58/67),高于增强CT法的64.18%(43/67)(P<0.05);CT影像组学法对阴性淋巴结转移的预测比率为100.00%(73/73),高于增强CT法的93.15%(68/73)(P<0.05);CT影像组学法预测到的金标准阳性组中发生淋巴结转移患者的风险评分值明显高于未发生淋巴结转移患者(P<0.05);金标准阳性组中CT影像组学对患者淋巴结转移预测的曲线下面积高于增强CT(P<0.05),金标准阴性组中CT影像组学对患者淋巴结转移预测的曲线下面积高于增强CT(P<0.05)。结论 与增强CT相比,CT影像组学在术前预测肺腺癌淋巴结转移阳性预测值和阴性预测值更高,具有更高的诊断价值。Objective To investigate the predictive value of CT-based radiomics in lymph node metastasis in stage T1 lung adenocarcinoma. Methods A total of 140 patients with lung adenocarcinoma admitted to our hospital from June 2016 to May2019 were retrospectively selected. With the results of pathological tissue samples in intraoperative examination as the gold standard, they were divided into the gold standard positive group(n=67) and the gold standard negative group(n=73).Preoperative enhanced CT and preoperative CT imaging were used to evaluate lymph node metastasis in the two groups.Delong test was used to evaluate the value of CT imaging and enhanced CT in predicting lymph node metastasis in both groups. Results In the two groups, the prediction ratioof positive lymph node metastasis by CT radiomics was 86.57%(58/67),which was higher than that by enhanced CT method [64.18%(43/67)](P<0.05). The prediction ratioof negative lymph node metastasis by CT radiomics was 100.00%(73/73), which was higher than that by enhanced CT [93.15%(68/73)](P<0.05). In the gold standard positive group, the risk score of patients with lymph node metastasis was significantly higher than that of patients without lymph node metastasisvia CT radiomics(P<0.05). In the gold standard positive group, the AUC area of CTradiomics in prediction of lymph node metastasiswas significantly higher than that of enhanced CT(P<0.05), and so was in the gold standard negative group(P<0.05). Conclusions Compared with enhanced CT, CT radiomics has a higher positive predictive value and negative predictive value for predicting lymph node metastasis of lung adenocarcinoma before surgery with high diagnostic value.

关 键 词：CT影像组学 肺腺癌 淋巴结转移 预测价值 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]