联合临床指标和MR征象的列线图预测肝细胞癌肿瘤包绕型血管  

Predicting vessels encapsulating tumor clusters in hepatocellular carcinoma using combination clinical biomarkers and MR features nomogram

作　　者：孟存忠 赵帆 盛玉武 MENG Cunzhong;ZHAO Fan;SHENG Yuwu(Department of CT/MRI,Wuwei People's Hospital,Wuwei 733000,China)

机构地区：[1]武威市人民医院CT/MRI科,武威733000

出　　处：《磁共振成像》2025年第3期58-62,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的 构建联合临床指标和MRI征象的列线图预测肝细胞癌(hepatocellular carcinoma,HCC)肿瘤包绕型血管(vessels encapsulating tumor clusters,VETC)。材料与方法 回顾性分析213例手术病理证实为HCC患者的临床及影像资料,根据时间顺序,按7∶3的比例将患者分为训练集和验证集,比较两组临床、病理及影像特征的差异。对训练集的临床指标及影像特征采用logistic单因素及多因素进行回归分析,确定VETC发生的独立危险因素。根据回归分析结果构建预测VETC的列线图,并在验证集中验证列线图的预测效能。结果 训练集纳入148例,验证集65例,两组临床、病理及影像特征差异无统计学意义(P均>0.05)。在训练集的logistic回归分析中,甲胎蛋白(alpha-fetoprotein,AFP)>400 ng/mL、肿瘤更大、肿瘤多发、肿瘤边缘不光整及出现肿瘤内动脉是预测VETC的独立危险因素。根据以上因素构建的列线图在训练集和验证集的C指数分别为0.825和0.817。结论 临床指标及MRI征象构建的列线图在预测VETC时具有较好的准确性,且能直观显示VETC的发生概率,可帮助临床制订个性化治疗的方案。Objective:To develop a nomogram combining clinical biomarkers and MRI features to predict vessels encapsulating tumor clusters(VETC) in hepatocellular carcinoma(HCC).Materials and Methods:Retrospective analysis of clinical and imaging data of 213patients with surgical pathologically confirmed HCC,and the patients were divided into training and validation cohorts in a ratio of 7∶3according to chronological order,and the differences in clinical,pathological and imaging features between the two groups were compared.Univariate and multivariate logistic regression analysis were used to analyze the independent risk factors,including clinical biomarkers and imaging features for VETC in training cohort.Nomogram for predicting VETC were developed based on the results of regression analysis,and this nomogram was validated using the validation cohort.Results:One hundred and forty-eight patients were included in the training cohort and 65 patients in the validation cohort,and there was no statistical difference in clinical,pathological and imaging features between the two groups.In the logistic regression analysis,AFP > 400 ng/mL,larger tumor diameter,greater number of tumors,non-smooth tumor margin and presence of intra-tumoral artery were the independent risk factors for predicting VETC.The C index of the nomogram developed based on the above factors was 0.825 and 0.817 in the training and validation cohort,respectively.Conclusions:The nomogram developed by clinical biomarkers and MRI features has good accuracy in predicting VETC and can directly visualize the probability of VETC,which can facilitate personalized treatment plans.

关 键 词：肝细胞癌 肿瘤包绕型血管 临床指标 磁共振成像 影像征象 列线图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]