摘要
目的:分析术前表观扩散系数图纹理分析对初治Ⅱ型子宫内膜癌盆腔淋巴转移的预测价值。方法:收集2019年12月至2022年12月于岳池县人民医院就诊的185例Ⅱ型子宫内膜癌患者的临床资料,根据患者是否出现盆腔淋巴转移分为转移组(62例)和未转移组(123例)。比较两组患者的临床资料和纹理参数。多因素分析影响患者盆腔淋巴转移的独立危险因素。采用受试者工作特征(ROC)曲线评估不同纹理参数单独及联合对患者盆腔淋巴转移的预测价值。构建列线图模型,通过ROC曲线和校准曲线评价模型区分度和准确度。采用Bootstrap重采样对列线图模型进行外部验证。结果:病理分级、肌层浸润深度、宫颈间质浸润、脉管浸润、ADCmin、峰值、熵值、偏度均为患者盆腔淋巴转移的独立危险因素(P<0.05)。ADCmin、峰值、熵值、偏度对患者盆腔淋巴转移有良好的预测价值,且四者联合诊断预测价值更高(AUC=0.833)。ROC曲线和校准曲线结果均显示列线图模型具有较好的区分度和校准度。结论:术前表观扩散系数图纹理分析对初治Ⅱ型子宫内膜癌盆腔淋巴转移具有一定预测价值,可作为评估患者盆腔淋巴转移的临床依据。
Objective:To analyze the predictive value of preoperative apparent diffusion coefficient map texture analysis on pelvic lymph node metastasis of newly treated typeⅡendometrial carcinoma.Methods:Collect the clinical data of 185 patients with typeⅡendometrial cancer who were treated in Yuechi County People's Hospital from December 2019 to December 2022.Patients were divided into metastatic group(62 cases)and non-metastatic group(123 cases)according to whether there was pelvic lymph metastasis.The clinical data and texture parameters of the two groups were compared.The independent risk factors of pelvic lymph metastasis were analyzed by multivariate analysis.The ROC curve was used to evaluate the predictive value of different texture parameters alone and in combination on pelvic lymph node metastasis in patients.Build nomograph model,and the model discrimination and accuracy were evaluated by ROC curve and calibration curve.Bootstrap resampling was used to externally verify the nomograph model.Results:Pathological grade,depth of myometrial invasion,cervical stromal invasion,vascular invasion,ADCmin,peak value,entropy value and skewness were all independent risk factors of pelvic lymph metastasis(P<0.05).ADCmin,peak value,entropy value and skewness had good predictive value for patients with pelvic lymph node metastasis,and the combined diagnostic predictive value of the four was higher(AUC=0.833).The ROC curve and calibration curve results showed that the nomogram model has good discrimination and calibration.Conclusion:The texture analysis of preoperative apparent diffusion coefficient map has certain predictive value for pelvic lymph node metastasis of newly treated typeⅡendometrial carcinoma,and can be used as a clinical basis for evaluating pelvic lymph node metastasis of patients.
作者
龙树林
周晓宇
陈利平
夏蜜
杨丹丹
Long Shulin;Zhou Xiaoyu;Chen Liping(Department of Obstetrics and Gynecology,Yuechi County People's Hospital,Guang'an 638300)
出处
《现代妇产科进展》
北大核心
2023年第8期561-565,共5页
Progress in Obstetrics and Gynecology
关键词
表观扩散系数图
纹理分析
Ⅱ型子宫内膜癌
盆腔淋巴转移
Apparent diffusion coefficient diagram
Texture analysis
TypeⅡendometrial carcinoma
Pelvic lymph metastasis
