基于CT特征的列线图鉴别长径≥1cm的腔内型胆囊癌及胆囊腺瘤的价值  

The value of the nomogram based on CT features in differentiating intraluminal gallbladder carcinoma and gallbladder adenoma with major axis≥1 cm

作　　者：张娟 冯亚园 吴钰娴 霍雷 刘一萍 张思斯 贾宁阳 ZHANG Juan;FENG Yayuan;WU Yuxian;HUO Lei;LIU Yiping;ZHANG Sisi;JIA Ningyang(Department of Radiology,the Third Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第三附属医院放射科,上海200433

出　　处：《实用放射学杂志》2022年第10期1625-1628,1667,共5页Journal of Practical Radiology

摘　　要：目的探讨基于CT特征的列线图对于鉴别长径≥1 cm的腔内型胆囊癌(GBC)和胆囊腺瘤(GA)的价值。方法回顾性分析≥1 cm的腔内型GBC 46例和GA 41例的临床表现、实验室指标和CT特征表现。采用单因素及最小绝对收缩与选择算子(LASSO)回归分析筛选独立预测因子,构建列线图预测模型,并通过受试者工作特征(ROC)曲线的曲线下面积(AUC)和校准曲线对其有效性进行评价。结果单因素分析显示年龄、白蛋白、糖类抗原19-9(CA19-9)、病灶长径、位置、是否为分叶状、基底情况、平扫CT值、动脉期CT值、门脉期CT值、延迟期CT值在2组间有统计学差异(P<0.05);经LASSO回归分析显示病灶长径、基底情况及延迟期CT值为区分腔内型GBC和GA的独立预测因子(P<0.05),结合CA19-9建立列线图模型;绘制ROC曲线显示AUC为0.936,校准AUC为0.922。结论基于病灶长径、基底情况、延迟期CT值和CA19-9建立的列线图模型可鉴别≥1 cm的腔内型GBC和GA,为临床治疗方式的选择提供重要信息。Objective To investigate the value of the nomogram based on CT features in differentiating intraluminal gallbladder carcinoma(GBC)and gallbladder adenoma(GA)with major axis≥1 cm.Methods A retrospective analysis of 46 cases of intraluminal GBC and 41 cases of GA with major axis≥l cm was performed,while the clinical manifestations,laboratory indexes,and CT features were analyzed.Univariate and least absolute shrinkage and selection operator(LASSO)regression analysis were used to screen independent predictors,a nomogram prediction model was constructed,and its validity was evaluated by receiver operating characteristic(ROC)curve area under the curve(AUC)and calibration curve.Results Univariate analysis showed that age,albumin,carbohydrate antigen 19-9(CA19-9),lesion length,location,lobulated or not,basal condition,plain scan CT value,arterial phase CT value,portal venous phase CT value,and delayed phase CT value were statistical differences between the two groups(P<0.05).LASSO regression analysis showed that the length of the lesion,basal condition,and delayed phase CT value were independent predictors for distinguishing intraluminal GBC and GA(P<0.05),furthermore combined with the CA19-9,a nomogram model was established.The ROC curve showed that the AUC was 0.936,and the AUC of the calibration curve was 0.922.Conclusion The nomogram model established based on the length of the lesion,basal condition,delayed phase CT value,and CA19-9 can differentiate intraluminal GBC and GA with major axis≥l cm,and provide important information for the selection of clinical treatment methods.

关 键 词：胆囊癌 胆囊腺瘤 列线图 计算机体层成像 

分 类 号：R735.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]