非小细胞肺癌淋巴结转移预测的研究进展  

Research progress on prediction of lymph node metastasis in non-small cell lung cancer

作　　者：汪洋 仲一凡 邓家骏 佘云浪 胡学飞[1] 陈昶[1] Wang Yang;Zhong Yifan;Deng Jiajun;She Yunlang;Hu Xuefei;Chen Chang(Department of Thoracic Surgery,Shanghai Pulmonary Hospital,Shanghai 200082,China)

机构地区：[1]同济大学附属上海市肺科医院胸外科,同济大学医学院,上海200082

出　　处：《中华胸心血管外科杂志》2022年第7期434-440,共7页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：术前准确预测淋巴结转移风险对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的肿瘤分期、治疗决策和预后评估具有重要意义。CT、MRI及PET/CT等单纯影像学方法是目前临床上最常用的评估淋巴结状态的手段,但是仅依靠影像形态特征的改变来判断淋巴结转移具有主观性,淋巴结炎性增生也会导致较高的假阳性率。通过分析NSCLC患者临床资料而获取的临床病理特征,可以在一定程度上提升淋巴结转移预测的准确性。结合医学图像的临床预测模型可为医师和患者提供更为直观理性的信息,但模型效能和适用性会随着疾病危险因素和治疗措施的改变而产生不可避免的下降。近年来,随着图像分析技术和计算能力的显著提高,基于医学图像的影像组学(radiomics)模型可深入挖掘医学影像中的数据进行定量分析,为预测NSCLC患者淋巴结转移提供新思路,受到国内、外的广泛关注。本文综述以上方法在NSCLC淋巴结转移预测中的研究进展以及展望。Accurately predicting the risk of mediastinal lymph node metastasis before surgery is of great significance for tumor staging,treatment plan decision,and prognosis evaluation in patients with non-small cell lung cancer(NSCLC).Traditional imaging methods such as CT,MRI and PET/CT are currently the most commonly used clinical methods in clinical evaluation of lymph node status.However,it is subjective to judge lymph node metastasis only by the change of image morphological characteristics,and inflammatory lymphadenopathy will also lead to a high false positive rate.The clinicopathological characteristics obtained by analyzing the clinical data of patients with NSCLC can improve the accuracy of lymph node metastasis prediction to a certain extent.The clinical prediction model based on medical images combined with the clinical characteristics of patients can provide more intuitive and rational information for doctors and patients,but the performance and applicability of the model will inevitably decrease due to changes in disease risk factors and treatment measures.In recent years,with the significant improvement of image analysis technology and computing ability,radiomics models based on medical images can deeply dig into the data in radiological images for quantitative analysis,providing new ideas for predicting mediastinal lymph node metastasis in NSCLC patients,which has attracted extensive attention at home and abroad.This article reviews the progress and makes prospects of the above methods in the prediction of mediastinal lymph node metastasis in NSCLC.

关 键 词：疾病危险因素 炎性增生 非小细胞肺癌 肿瘤分期 影像学方法 影像组学 图像分析技术 淋巴结转移 

分 类 号：R734.2[医药卫生—肿瘤]