术前CT征象联合临床指标预测肝细胞癌中CK19的表达  

Preoperative CT signs combined with clinical indicators predict the expression of cytokeratin 19 in hepatocellular carcinoma

作　　者：张思怡 黄向阳[1] 覃云英 刘丽娟[1] 黄彩云 罗宁斌[1] ZHANG Siyi;HUANG Xiangyang;QIN Yunying;LIU Lijuan;HUANG Caiyun;LUO Ningbin(Medical Imaging Center,Guangxi Medical University Cancer Hospital,Guangxi Key Clinical Specialty(Medical Imaging Department),Dominant Cultivation Discipline of Guangxi Medical University Cancer Hospital(Medical Imaging Department),Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像中心,广西临床重点专科(医学影像科),广西医科大学附属肿瘤医院优势培育学科(医学影像科),南宁530021

出　　处：《中国癌症防治杂志》2024年第4期461-467,共7页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：广西科技基地和人才专项(桂科AD20238096);广西医科大学青年科学基金项目(GXMUYSF202119,GXMUYSF202227)。

摘　　要：目的 探讨术前CT征象联合临床指标预测肝细胞癌(hepatocellular carcinoma,HCC)患者细胞角蛋白19(cytokeratin 19,CK19)表达的价值。方法 选择2019年1月—2021年12月在广西医科大学附属肿瘤医院治疗的HCC患者为研究对象。收集其临床数据以及CT征象,并按照7∶3的比例随机分为训练组和验证组。采用向后逐步Logistic回归分析CK19表达的独立预测因子并构建预测模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线、校准曲线和决策曲线评估该模型预测效能。结果 共纳入380例HCC患者,其中68(17.9%)例CK19阳性。年龄、AFP、动脉期环形强化、中央延迟强化、瘤内动脉是HCC中CK19表达的独立预测因子(均P<0.05)。训练组和验证组的临床影像模型预测CK19表达的曲线下面积(area under the curve,AUC)分别为0.789、0.748。校准曲线显示,临床影像模型拟合度良好;决策曲线显示,临床影像模型具有较好的临床应用价值。结论 术前CT征象联合年龄、AFP预测HCC患者的CK19表达具有良好的效能。Objective To investigate the value of preoperative CT signs combined with clinical indicators in predicting the expression of cytokeratin 19(CK19)in patients with hepatocellular carcinoma(HCC).Methods HCC patients admitted to Guangxi Medical University Cancer Hospital from January 2019 to December 2021 were enrolled as the studied objects.The clinical data and CT signs were collected and randomly divided into training group and validation group according to a ratio of 7:3.The independent predictors of CK19 expression was analyzed by Logistic backward stepwise regression and a predictive model was constructed.The receiver operating characteristic(ROC)curve,calibration curve,and decision curve were used to evaluate the predictive efficacy of the model.Results A total of 380 HCC patients were enrolled,of which 68(17.9%)were CK19 positive.Age,AFP,rim arterial phase hyperenhancement,delayed central enhancement,and intratumoral artery were independent predictors of CK19 expression in HCC(all P<0.05).The area under the curve(AUC)of CK19 expression predicted by the clinical imaging model in the training group and validation group was 0.789 and 0.748,respectively.The calibration curve showed a good fitting degree of the clinical imaging model.The decision curve showed that the clinical image model had good clinical application value.Conclusions Preoperative CT signs combined with age and AFP effectively predict CK19 expression in HCC patients.

关 键 词：肝细胞癌 CT征象 细胞角蛋白19 

分 类 号：R735.7[医药卫生—肿瘤]