基于多模态MRI特征的诺谟图模型诊断直肠癌侧方淋巴结的临床价值研究  

Clinical value of nomogram model for diagnosis of lateral lymph nodes of rectal cancer based on multimodal MRI features

作　　者：代洁 李扬 王可欣 徐青 唐俊伟 封益飞 余静 DAI Jie;LI Yang;WANG Kexin;XU Qing;TANG Junwei;FENG Yifei;YU Jing(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210003,China;Department of Colorectal Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210003,China;Department of Pathology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210003,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210003 [2]南京医科大学第一附属医院结直肠外科,江苏南京210003 [3]南京医科大学第一附属医院病理科,江苏南京210003

出　　处：《实用放射学杂志》2023年第8期1266-1271,共6页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81801662)。

摘　　要：目的探讨直肠癌侧方淋巴结转移(LLNM)的危险因素并基于这些危险因素构建诺谟图诊断LLNM。方法回顾性分析93例经病理证实为直肠腺癌并行直肠癌根治术+侧方淋巴结清扫术患者。收集直肠癌临床及影像特征指标,运用单因素及多因素逻辑回归识别LLNM的独立危险因素,基于这些危险因素建立诺谟图,受试者工作特征(ROC)曲线分析及校准图用于评估该模型的效能。结果更长的侧方淋巴结短径、不清晰的侧方淋巴结边界及直肠系膜脂肪信号混杂是LLNM的独立危险因素。在训练组及验证组中,基于独立危险因素建立的诺谟图的曲线下面积(AUC)分别为0.926、0.922。结论基于独立危险因素建立的诺谟图有助于诊断LLNM,从而更好地指导临床制订个体化治疗方案。Objective To investigate the risk factors for lateral lymph node metastasis(LLNM)in rectal cancer and develop a nomogram based on the risk factors to diagnose LLNM.Methods A total of 93 patients with pathologically confirmed rectal adenocarcinoma who underwent radical rectal cancer surgery and lateral lymph node dissection were analyzed retrospectively.Clinical and imaging characteristics of rectal cancer indicators were collected,and independent risk factors for LLNM were identified using univariate and multivariate logistic regression,and a nomogram was developed based on these risk factors.The receiver operating characteristic(ROC)curve analysis and calibration curve were used to evaluate the model's performance.Results Longer short-axis diameter of lateral lymph node,blurred edge of lateral lymph node,and heterogeneous signal intensity in mesenteric fat spaces were independent risk factors of LLNM.The area under the curve(AUC)of the nomogram based on the variables above was 0.926 and 0.922,respectively in the training and validation cohort.Conclusion The nomogram based on the independent risk factors above can help diagnose LLNM and thus better guide individualized clinical treatment.

关 键 词：直肠癌 侧方淋巴结转移 侧方淋巴结清扫术 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]