增强CT联合纹理分析对非小细胞肺癌术前纵隔淋巴结转移的评估价值  

Evaluation value of preoperative mediastinal lymph node metastasis in non-small cell lung cancer using enhanced CT combined with texture analysis

作　　者：刘洋[1] 李新振 夏亮 常潇月 LIU Yang;LI Xinzhen;XIA Liang;CHANG Xiaoyue(Department of Thoracic Surgery,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 110112,China;Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]首都医科大学附属北京潞河医院胸外科,北京1101122 [2]河北医科大学,河北石家庄050000

出　　处：《医学影像学杂志》2025年第3期51-55,共5页Journal of Medical Imaging

基　　金：河北省自然科学基金资助项目(编号:H2024206158)。

摘　　要：目的 探讨增强CT扫描联合纹理分析对非小细胞肺癌(NSCLC)术前纵隔淋巴结转移的评估价值。方法 选取本院经病理证实的110例NSCLC患者,均行增强CT扫描+纹理分析检查,CT检查完成后行肺癌根治术。根据手术病理结果评估纵隔淋巴结转移情况,以手术采集的病理标本检查结果为金标准,评估增强CT扫描联合纹理分析对NSCLC纵隔淋巴结转移的评估价值。结果 共110例NSCLC患者行肺癌根治术治疗,根据术中探查情况行纵隔淋巴结清扫或采样术,病理诊断淋巴结阳性35例,纵隔淋巴结转移率约31.82%。增强CT和CT纹理分析评估NSCLC纵隔淋巴结转移与病理结果均具有中等一致性(Kappa=0.439、0.463,P<0.05)。采用增强CT联合纹理分析评估NSCLC纵隔淋巴结转移,联合评估与病理结果具有高度一致性(Kappa=0.734,P<0.05),且联合评估的准确度、特异度均高于增强CT扫描与纹理分析单独评估比较,差异有统计学意义(P<0.05)。结论 增强CT扫描和纹理分析评估NSCLC纵隔淋巴结转移与病理结果均有一致性,联合评估的一致性最强,较二者单独应用评估价值更好。Objective To explore the evaluation value of enhanced CT scanning combined with texture analysis for preopera-tive mediastinal lymph node metastasis in non small-cell lung cancer(NSCLC).Methods A total of 110 NSCLC patients con-firmed by biopsy pathology in our hospital were selected.All patients underwent enhanced CT scanning and texture analysis ex-amination.After completing the CT examination,lung cancer radical surgery was performed.The mediastinal lymph node metas-tasis was evaluated according to the results of surgical pathology.The results of pathological specimens collected by surgery were used as the gold standard to evaluate the value of enhanced CT scan combined with texture analysis in the evaluation of mediasti-nal lymph node metastasis of NSCLC.Results A total of 110 NSCLC patients underwent radical surgery for lung cancer,and mediastinal lymph node dissection or sampling surgery was performed based on intraoperative exploration.Pathological diagnosis showed positive lymph nodes in 35 cases,with a mediastinal lymph node metastasis rate of about 31.82%.The evaluation of me-diastinal lymph node metastasis in NSCLC by enhanced CT and CT texture analysis showed moderate consistency with pathologi-cal results(Kappa=0.439,0.463,P<0.05).The use of enhanced CT combined with texture analysis to evaluate mediastinal lymph node metastasis in NSCLC showed a high degree of consistency with pathological results(Kappa=0.734,P<0.05),and the accuracy and specificity of the combined evaluation were higher than those of enhanced CT and texture analysis alone(P<0.05).Conclusion The evaluation of mediastinal lymph node metastasis in NSCLC using enhanced CT scanning and texture analysis is consistent with pathological results,and the consistency is strongest when evaluated in combination,with better value compared to their individual application or evaluation.

关 键 词：非小细胞肺癌 纵隔淋巴结转移 体层摄影术 X线计算机 纹理分析 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]