基于超声组学预测CN0期峡部甲状腺乳头状癌中央区淋巴结转移  

Ultrasound Radiomics for Predicting Central Lymph Node Metastasis in CNO Stage Isthmic Papillary Thyroid Carcinoma

作　　者：李鑫焱 张文鑫 杨玉娥 孙芳[1] Li Xinyan;Zhang Wenxin;Yang Yue;Sun Fang(Department of Ultrasound,Binzhou Medical University Hospital,Binzhou,Shandong 256603,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东省滨州市256603

出　　处：《中国超声医学杂志》2025年第3期253-256,共4页Chinese Journal of Ultrasound in Medicine

基　　金：山东省自然科学基金项目(No.ZR2023MH348)。

摘　　要：目的 探讨超声组学联合临床及超声特征预测CN0期峡部甲状腺乳头状癌(IPTC)中央区淋巴结转移(CLNM)的价值。方法 本研究对150例IPTC患者的临床信息和超声图像进行回顾性分析。利用单因素和多因素分析识别独立预测因素。基于超声图像提取影像组学特征,筛选后构建影像组学评分,并结合独立预测因素建立列线图。通过受试者工作特征曲线下面积(AUC)评估列线图的预测效能,并通过临床决策曲线分析(DCA)其临床收益。结果 年龄和包膜侵犯是IPTC患者CLNM的独立预测因素,联合后的AUC为0.722。研究筛选出18个特征构建影像组学评分,并将年龄、包膜侵犯与影像组学评分联合构建列线图,AUC提高至0.822。DCA曲线显示列线图在广泛阈值概率范围内具有更高的临床净收益。结论 超声组学联合临床及超声特征一定程度上可以预测CN0期IPTC患者CLNM,指导临床决策的制订。Objective This research seeked to assess the effectiveness of combining ultrasound radiomics with clinical and ultrasound features for predicting central compartment lymph node metastasis(CLNM)in CNO stage isth-mic papillary thyroid carcinoma(IPTC).Methods A retrospective analysis was performed on the clinical and ultra-sound data of 150 IPTC patients.Through univariate and multivariate analyses,independent predictive factors were identified.Radiomics features were extracted from ultrasound images and were used to develop a radiomics score after selection.This was integrated with independent predictive factors to construct a nomogram.The nomogram's predic-tive capability was evaluated by the area under the receiver operating characteristic curve(AUC),and its clinical utility was examined via decision curve analysis(DCA).Results Age and capsular invasion were determined to be independ-ent predictors of CLNM in IPTC patients,with a combined AUC of o.722.Eighteen features were selected to form the radiomics score,and when combined with age and capsular invasion,the nomogram's AUC increased to 0.822.The DCA curve revealed a higher net clinical benefit over a wide range of threshold probabilities.Conclusions sUltra-sound radiomics,when combined with clinical and ultrasound features,can predict CLNM in CNO stage IPTC pa-tients,aiding clinical decision-making processes.

关 键 词：超声 影像组学 中央区淋巴结转移 甲状腺乳头状癌 峡部 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]