基于超声多参数建立Logistic回归模型预测宫颈癌放化疗预后转归  

Establishment of a logistic regression model based on ultrasound multi-parameters to predict the prognosis of cervical cancer radiotherapy and chemotherapy

作　　者：陈鲜霞[1] 康茜 马钦风[1] 宋海红[1] 张玉英[1] 尹秋萍[1] 贺鑫媛 CHEN Xianxia;KANG Xi;MA Qinfeng;SONG Haihong;ZHANG Yuying;YIN Qiuping;HE Xinyuan(Department of Ultrasound,Qinghai Provincial People's Hospital,Xining 810007,China;Graduate Sehool of Qinghai Universite,Xining 810007,China)

机构地区：[1]青海省人民医院超声科,青海西宁810007 [2]青海大学研究生院,青海西宁810007

出　　处：《医学影像学杂志》2024年第12期126-130,共5页Journal of Medical Imaging

基　　金：青海省卫生健康委员会指导性计划课题(编号:2021-wjzdx-37)。

摘　　要：目的探讨采用Logistic回归方程分析影响宫颈癌放化疗预后转归的危险因素,并基于超声多参数建立Lo⁃gistic回归模型预测宫颈癌放化疗预后转归。方法选取100例中晚期宫颈癌患者,均接受三维适形放射治疗(3D-CRT)联合化疗法,随访3年。根据生存情况分为死亡组以及存活组,采用Logistic模型分析影响预后的危险因素,并基于超声多参数建立Logistic回归模型预测宫颈癌放化疗预后转归,采用受试者特征工作(ROC)曲线评估模型预测效能。结果死亡组的FIGO分期多为Ⅲ~Ⅳ期,且弹性评分、病变应变率、病灶剪切波速度(SWV)高于存活组,差异有统计学意义(P<0.05)。Logistic回归分析显示,FIGO分期Ⅲ~Ⅳ期以及弹性评分、病变应变率、病灶SWV高值患者不良预后风险较高,差异有统计学意义(P<0.05)。弹性评分、病变应变率、SWV高值患者的3年生存率均低于低值患者,差异有统计学意义(P<0.05)。ROC曲线分析显示弹性评分、病变应变率、SWV以及预测模型预测宫颈癌患者不良预后的曲线下面积(AUC)分别为0.779(95%CI:0.683~0.874)、0.775(95%CI:0.675~0.874)、0.761(95%CI:0.655~0.868)、0.873(95%CI:0.795~0.950),预测模型预测不良预后的AUC高于超声参数,差异有统计学意义(P<0.05)。结论宫颈癌患者放化疗后的超声参数(弹性评分、病变应变率、病灶剪切波速度)与预后密切关联,死亡组超声参数值较高,且基于超声多参数建立的Logistic回归模型可有效预测患者预后情况。Objective By means of Logistic regression,to analyze the risk factors affecting the prognosis of cervical cancer radiotherapy and chemotherapy,and to establish a Logistic regression model based on ultrasound multi-parameters to predict the prognosis of cervical cancer radiotherapy and chemotherapy.Methods A total of 100 patients with advanced cervix were selected.All patients received three-dimensional conformal radiotherapy(3D-CRT)combined with chemotherapy,and were followed up for 3 years.According to the survival situation,the patients were divided into death group and survival group.Logistic model was used to analyze the risk factors affecting the prognosis,and Logistic regression model was established based on ultrasonic multiple parameters to predict the prognosis of cervical cancer chemotherapy,and receiver characteristic operating curve(ROC)was used to evaluate the prediction efficiency of the model.Results FIGO staging in the death group was mostly stage Ⅲ to Stage Ⅳ,and the elasticity score,lesion strain rate and lesion shear wave velocity were higher than those in the survival group(P<0.05).Logistic regression analysis showed that patients with high values of FIGO stage Ⅲ to Ⅳ,elasticity score,lesion strain rate and focal shear wave velocity had a higher risk of poor prognosis(P<0.05).The 3-year survival rate of patients with high elasticity score,lesion strain rate,and focal shear wave velocity was lower than that of patients with low elasticity score(P<0.05).ROC curve analysis showed that the AUCs of elasticity score,lesion strain rate,focal shear wave velocity and prediction model to predict poor prognosis of cervical cancer patients were 0.779(95%CI 0.683~0.874),0.775(95%CI 0.675~0.874)and 0.761(95%CI,respectively 0.655~0.868),0.873(95%CI 0.795~0.950),the AUC of prediction model for poor prognosis was higher than that of ultrasonic parameters(P<0.05).Conclusion Ultrasound parameters(elasticity score,lesion strain rate,lesion shear wave velocity)after radiotherapy and chemotherapy in cervica

关 键 词：超声检查 弹性评分 病灶剪切波速度 宫颈癌 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]