CT特征及临床指标在儿童肝母细胞瘤病理分型的预测价值分析  

Study on the predictive value of CT imaging features and clinical indicators in the pathological classification of pediatric hepatoblastoma

作　　者：李钱程 王伟 张龚巍[3] 李世宪 李成龙 徐超 于啸 王晗 LI Qiancheng;WANG Wei;ZHANG Gongwei;LI Shixian;LI Chenglong;XU Chao;YU Xiao;WANG Han(Department of Radiology,Xuzhou Children’s Hospital,Xuzhou 221000,China;Department of Neonatology,Xuzhou Children’s Hospital,Xuzhou 221000,China;Department of Radiology,Shenzhen Children’s Hospital,Shenzhen 518026,China;Department of General Surgery,Xuzhou Children’s Hospital,Xuzhou 221000,China;Department of Pathology,Xuzhou Children’s Hospital,Xuzhou 221000,China)

机构地区：[1]江苏省徐州市儿童医院放射科,江苏徐州221000 [2]江苏省徐州市儿童医院新生儿科,江苏徐州221000 [3]广东省深圳市儿童医院放射科,广东深圳518026 [4]江苏省徐州市儿童医院普外科,江苏徐州221000 [5]江苏省徐州市儿童医院病理科,江苏徐州221000

出　　处：《医学影像学杂志》2025年第2期74-79,共6页Journal of Medical Imaging

基　　金：江苏省徐州市卫生健康委医学科技项目(编号:XWKYHT20230018)。

摘　　要：目的通过分析儿童肝母细胞瘤(HB)不同病理分型患儿CT特征及临床指标的差异,探讨相关指标在HB病理分型预测中的价值。方法选取我院收治的49例HB患儿,根据病理分型分为混合性上皮型25例(混合型组)、完全上皮型24例(上皮型组)。收集患儿的CT特征及临床资料,采用单因素分析、二元Logistic回归分析儿童HB不同病理分型的临床特点及影响因素,使用受试者工作特征(ROC)曲线评价相关指标在HB病理分型预测中的价值。结果不同HB病理类型组在年龄、钙化、包膜回缩发生率上差异有统计学意义;二元Logistic回归分析结果显示,年龄、包膜回缩为儿童HB病理分型的独立影响因素;基于以上2个指标构建评价模型的AUC值为0.837(95%CI:0.720~0.953),敏感度、特异度分别为81.76%、95.47%,预测模型拟合度较好(Hosmer-Lemeshow χ^(2)=7.365,P=0.498)。结论年龄、包膜回缩为预测儿童HB病理分型的独立影响因素,基于以上2个指标构建的评价模型对儿童HB病理分型具有较高的预测价值,可以为儿童HB临床决策提供依据。Objective To analyze the differences of CT imaging features and clinical indicators of children with hepatoblastoma(HB)and to explore the value of relevant indicators in the prediction of HB pathological classification.Methods 49 cases of HB admitted to Xuzhou Children's Hospital from January 2014 to December 2023 were included in this study,and divided into two groups according to pathological classification:mixed epithelial mesenchymal type(25 cases)and complete epithelial type(24 cases).The imaging and clinical data of all children with different pathological types were analyzed by Univariate analysis and Binary logistic regression,and the value of relevant indicators in HB pathological classification prediction was evaluated by the use of the receiver working characteristic curve(ROC).Results There were significant differences in age,calcification and envelope retraction among different pathological types.Binary logistic regression analysis showed that age and capsule retraction were the independent influencing factors of HB in children.The area under the ROC curve of the evaluation model constructed based on the above two indexes was 0.837(95%CI:0.720-0.953),the sensitivity and specificity were 81.76% and 95.47% respectively,which were higher than each single index in the model,and the fitting degree of the evaluation model was good(Hosmer-Lemeshow χ^(2)=7.365,P=0.498).Conclusion Age and capsule regression are independent influencing factors to predict the pathological classification of HB in children.The evaluation model constructed based on the above two indexes has high predictive value for the pathological classification of HB in children,which can provide a basis for the clinical decisionmaking of HB in children.

关 键 词：体层摄影术 X线计算机 临床指标 儿童 肝母细胞瘤 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]