影响眼周皮脂腺癌预后中的高频超声征象分析  

The application value of high frequency ultrasound in evaluating the prognosis of periocular sebaceous gland carcinom

作　　者：马丙鑫 吴刚 朱好辉 许梅 赵婧革 刘祎斐 李闯 MA Bingxin;WU Gang;ZHU Haohui;XU Mei;ZHAO Jingge;LIU Yifei;LI Chuang(Department of Ultrasound,Henan Provincial People’s Hospital,People’s Hospital of Zhengzhou University,People's Hospital ofHenan University,Zhengzhou 450003,China;Department of Pathology,Henan Provincial People's Hospital,People’s Hospital of Zhengzhou University,People's Hospital ofHenan University,Zhengzhou 450003,China;Department of Clinical Research Center,Henan Provincial People's Hospital,People’s Hospital of Zhengzhou University,People's Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院郑州大学人民医院、河南大学人民医院超声科,河南郑州450003 [2]河南省人民医院郑州大学人民医院、河南大学人民医院病理科,河南郑州450003 [3]河南省人民医院郑州大学人民医院、河南大学人民医院临床研究中心,河南郑州450003

出　　处：《医学影像学杂志》2023年第6期948-952,共5页Journal of Medical Imaging

基　　金：河南省科技厅科技攻关基金项目(编号:212102310652)。

摘　　要：目的探讨眼周皮脂腺癌(periocular sebaceous gland carcinoma,PSGC)的临床及超声影像特征,评价高频超声相关参数在预测PSGC预后中的应用价值。方法选取本院行超声检查并经术后病理确诊的36例PSGC患者(共36个病灶)资料,根据随访患者术后复发情况,分析复发组(11例)和未复发组(25例)间患者的性别、年龄、病程、病灶位置和大小、病理分型及超声声像图表现等相关参数。结果36例患者中平均复发率为30.1%。单因素分析显示:患者的病程时间、病灶的位置、形态、液化、血流分级、峰值流速、阻力指数及病理分型在复发组和未复发组间比较差异无统计学意义(P>0.05);而性别、病灶大小(最大径>15mm)、病灶内钙化与PSGC复发相关,差异有统计学意义(P<005)。采用ROC曲线分析病灶大小对PSGC术后复发的诊断效能,AUC为0.818,当截断值为15mm时特异性为88.0%,敏感性为72.7%,Youden指数为0.607。两因素分析显示:通过调整协变量后,病灶大小诊断复发与否的ROC曲线下面积为0.765,95%CI为(0.573,0.958)。结论高频超声检查有助于PSGC的诊断,超声声像图多表现为低回声包块,中心放射状丰富血流为其特征。病灶大小、有无钙化在评估眼周皮质腺癌复发中有一定的预测价值。Objective To evaluate the value of high-frequency ultrasound related parameters in predicting the prognosis of periocular sebaceous adenocarcinoma(PSGC)by observing and to analyze the clinical and ultrasonic imaging characteristics of PSGC.Methods The data of 36 patients(36 lesions in total)with PSGC diagnosed by postoperative pathology were selected.According to the follow-up observation of postoperative recurrence,the related parameters such as gender,age,incidence cycle,lesion location,size,pathological classification and ultrasonic imaging between the recurrence group and the nonrecurrence group were analyzed.Result Among the 36 patients,the recurrence rate was about 30.1%.Univariate regression analysis showed that gender,lesion size(max diameter>15mm)and intralesion calcification were correlated with PSGC recurrence(P<0.05).The duration of disease,location,morphology,liquefaction,blood flow grade,peak flow velocity,resistance index and pathological classification of patients had no significant statistical significance between recurrent group and nonrecurrent group(P>0.05).ROC curve was used to analyze the diagnostic efficacy of maximum lesion diameter for recurrence after PSGC.When the cutoff value was 15mm,AUC was 0.818,specificity was 88.0%,sensitivity was 72.7%,and Youden index was 0.607.Two factor analysis showed that after adjusting the covariates,the area under the ROC curve for the diagnosis of recurrence was 0.765,and the 95%CI was(0.573,0.958).Conclusion High frequency ultrasonography is helpful to the diagnosis of periocular SGC.Its ultrasonic images are characterized by hypoechoic mass and rich radial blood flow in the center.The size and calcification of the lesion have a certain predictive value in evaluating the postoperative recurrence of periocular sebaceous adenocarcinoma.

关 键 词：超声检查 高频 眼周 皮脂腺肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.7[医药卫生—诊断学]