CT征象联合临床特征在预测实性肺腺癌脏层胸膜侵犯中的价值  

Value of CT signs combined with clinical features in predicting visceral pleural invasion of solid lung adenocarcinoma

作　　者：蔡晓婷 王萍[2] 林杨 杨薪玉 马恒 CAI Xiaoting;WANG Ping;LIN Yang;YANG Xinyu;MA Heng(School of Medical Imaging,Binzhou Medical University,Yantai,Shandong Province 264003,China;Department of Imaging,Yantai Yuhuangding Hospital,Qingdao University,Yantai,Shandong Province 264000,China;School of Public Health and Management,Binzhou Medical University,Yantai,Shandong Province 264003,China)

机构地区：[1]滨州医学院医学影像学院,山东烟台264003 [2]青岛大学附属烟台毓璜顶医院影像科,山东烟台264000 [3]滨州医学院公共卫生与管理学院,山东烟台264003

出　　处：《实用放射学杂志》2023年第6期912-915,953,共5页Journal of Practical Radiology

摘　　要：目的通过CT征象联合临床特征构建模型,预测实性肺腺癌是否存在脏层胸膜侵犯(VPI)。方法分析326例实性肺腺癌患者的CT征象及临床特征,将患者分为VPI阳性组和VPI阴性组。通过单因素分析和多因素logistic回归分析确定VPI的独立危险因素。通过受试者工作特征(ROC)曲线及曲线下面积(AUC)验证各独立模型及联合模型性能。结果肿瘤与胸膜关系、纵隔窗大小及淋巴结增大为VPI的独立危险因素(P<0.001)。ROC曲线显示基于三者联合的模型有最好的预测效能(AUC 0.802)。结论肿瘤与胸膜关系、纵隔窗大小及淋巴结增大是实性肺腺癌VPI的独立危险因素,基于三者联合的模型对实性肺腺癌VPI有较高的预测效能。Objective To construct a model to predict the presence or absence of visceral pleural invasion(VPI)in solid lung adenocarcinoma by CT signs combined with clinical features.Methods The CT signs and clinical features of 326 patients with solid lung adenocarcinoma were analyzed.The patients were divided into positive-and negative-VPI groups.Univariate analysis and multivariate logistic regression analysis were performed to determine the independent risk factors for VPI.The performances of each independent model and combined model were verified by the receiver operating characteristic(ROC)curve and area under the curve(AUC).Results The relation between tumor and pleura,mediastinal window size,and lymph node enlargement were independent risk factors for VPI(P<0.001).The ROC curve showed that the model based on the combination of the three risk factors had the best predictive efficacy with a AUC of 0.802.Conclusion The relation between tumor and pleura,mediastinal window size,and lymph node enlargement are independent risk factors for VPI in solid lung adenocarcinoma,and the model based on the combination of the three risk factors has superior predictive efficacy for VPI in solid lung adenocarcinoma.

关 键 词：肺 腺癌 脏层胸膜侵犯 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]