基于双期增强CT检查影像组学胆囊癌淋巴结转移预测模型构建及其应用价值  

Establishment and application value of a radiomics prediction model for lymph node metas-tasis of gallbladder carcinoma based on dual-phase enhanced CT

作　　者：李起 金哲川 张东[1] 陈晨[1] 张健[1] 张景玮 蔡志强[2] 司书宾[2] 杨敏[3] 王秋萍[3] 耿智敏[1] 刘青光[1] Li Qi;Jin Zhechuan;Zhang Dong;Chen Chen;Zhang Jian;Zhang Jingwei;Cai Zhiqiang;Si Shubin;Yang Min;Wang Qiuping;Geng Zhimin;Liu Qingguang(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Industrial Engineering,School of Mechanical Engineering,Northwestern Polytechnical University,Xi'an 710072,China;Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,西安710061 [2]西北工业大学机电学院工业工程系,西安710072 [3]西安交通大学第一附属医院医学影像科,西安710061

出　　处：《中华消化外科杂志》2022年第7期931-940,共10页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(62076194);陕西省重点研发计划(2022SF‑606)。

摘　　要：目的探讨基于双期增强CT检查影像组学胆囊癌淋巴结转移预测模型构建及其应用价值。方法采用回顾性队列研究方法。收集2012年1月至2020年12月西安交通大学第一附属医院收治的194例胆囊癌患者的临床病理资料;男70例,女124例;年龄为(64±10)岁;均行胆囊癌意向性根治切除术。194例患者通过R软件随机数法以8∶2比例随机分为训练集156例和测试集38例。训练集用于构建诊断模型,测试集用于验证诊断模型。患者进行CT检查后,行图像分析、提取影像组学特征、影像组学模型建立;根据临床病理因素构建列线图预测模型。观察指标:(1)淋巴结清扫及组织病理学检查结果。(2)影像组学预测模型构建及特征分析。(3)胆囊癌淋巴结转移的影响因素分析。(4)列线图淋巴结转移预测模型构建。(5)影像组学及列线图淋巴结转移预测模型的预测能力比较。正态分布的计量资料以x±s表示,偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示,组间比较采用χ^(2)检验。单因素分析采用χ^(2)检验,多因素分析采用Logistic回归模型前进法。绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)、决策曲线、混淆矩阵进行预测模型的效能评价。结果(1)淋巴结清扫及组织病理学检查结果。194例患者中,行淋巴结清扫182例,淋巴结清扫数目为8(1~34)枚/人,阳性淋巴结清扫数目为0(0~11)枚/人。194例患者术后组织病理学检查结果显示:N0期122例,淋巴结清扫数目为7(0~27)枚/人;N1期48例,淋巴结清扫数目为8(2~34)枚/人,阳性淋巴结清扫数目为1(1~3)枚/人;N2期24例,淋巴结清扫数目为11(2~20)枚/人,阳性淋巴结清扫数目为5(4~11)枚/人。(2)影像组学预测模型构建及特征分析。提取194例患者107个影像组学特征,其中一阶特征18个、形状特征14个、纹理特征75个。通过各影像组学特征组内相关系数及绝对中位差和使用互�Objective To investigate the establishment and application value of a radio-mics prediction model for lymph node metastasis of gallbladder carcinoma based on dual-phase enhanced computed tomography(CT).Methods The retrospective cohort study was conducted.The clinicopathological data of 194 patients with gallbladder carcinoma who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2012 to December 2020 were collected.There were 70 males and 124 females,aged(64±10)years.All patients underwent curative-intent rsection of gallbladder carcinoma.A total of 194 patients were randomly divided into 156 cases in training set and 38 cases in test set according to the ratio of 8:2 based on random number method in R software.The training set was used to establish a diagnostic model,and the test set was used to validate the diagnostic model.After the patients undergoing CT examination,image analysis was performed,radiomics features were extracted,and a radiomics model was established.Based on clinicopathological data,a nomogram prediction model was tablished.Observation indicators:(1)lymph node dissection and histopathological examination results;(2)establishment and characteristic analysis of a radiomics prediction model;(3)analysis of influencing factors for lymph node metastasis of gallbladder carcinoma;(4)establishment of a nomogram prediction model for lymph node metastasis;(5)comparison of the predictive ability between the radiomics prediction model and nomogram prediction model for lymph node metastasis.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M(range).Count data were expressed as absolute numbers,and comparison between groups was performed by the chi-square test.Univariate analysis was conducted by the chi-square test,and multivariate analysis was performed by the Logistic regression model forward method.The receiver operating characteristic curve was drawn,and the area under curve,deci

关 键 词：胆道肿瘤 影像组学 列线图 淋巴结转移 影响因素 预后 

分 类 号：R735.8[医药卫生—肿瘤]