摘要
目的分析基于弥散峰度成像(DKI)直方图的影像学特征构建宫颈癌预后的价值。方法回顾性分析2015年3月至2022年2月于广东医科大学附属医院就诊的272例宫颈癌患者,收集患者的DKI以及临床资料,以7∶3比例随机分为训练组(190例)和验证组(82例)。经GE AW 4.2 MRI软件获得DKI直方图参数特征,LASSO回归筛选预后最佳影像特征,线性组合计算DKI影像组学评分,单因素及多因素回归分析预后独立危险因素,构建列线图模型。采用受试者操作特征(ROC)曲线的曲线下面积(AUC)评估模型区分度,用校准图评估模型内部一致性情况。结果腺癌(HR=2.496,95%CI为1.312~4.749,P=0.005)、DKI评分(HR=24.087,95%CI为6.062~95.711,P<0.001)、浸润深度≥1/2肌层(HR=2.277,95%CI为1.156~4.487,P=0.017)和中性粒细胞/淋巴细胞比值(NLR,HR=1.800,95%CI为1.313~2.468,P<0.001)是宫颈癌预后独立危险因素。列线图模型在训练组和验证组AUC分别为0.860和0.757,校准曲线与45°对角线拟合情况较好,模型对远期预后预测结果与实际情况一致性良好。结论腺癌、NLR、DKI评分、浸润深度≥1/2肌层均为宫颈癌患者预后的独立危险因素,构建的列线图模型能够可靠地预测宫颈癌患者3年生存率。
Objective To analyze the prognostic value of nomogram model for cervical cancer based on the imaging features of diffusion kurtosis imaging(DKI)histogram.Methods The DKI and clinical data of 272 patients with cervical cancer who were admitted to Affiliated Hospital of Guangdong Medical University from March 2015 to February 2022 were collected and retrospectively analyzed.All patients were randomly divided into the training group(n=190)and validation group(n=82)at a ratio of 7 vs.3.The parameters of DKI histogram were obtained by GE AW 4.2 MRI software.The best prognostic imaging features were screened by LASSO regression.The DKI radiomics score was calculated by linear combination.The independent risk factors of prognosis were identified by univariate and multivariate regression analyses,and a nomogram model was constructed.The model discrimination was assessed by the area under the receiver operating characteristic(ROC)curve(AUC).The internal consistency of the model was evaluated by the calibration map.Results Adenocarcinoma(HR=2.496,95%CI=1.312-4.749,P=0.005),DKI score(HR=24.087,95%CI=6.062-95.711,P<0.001),depth of invasion≥1/2 muscular layer(HR=2.277,95%CI=1.156-4.487,P=0.017)and neutrophil to lymphocyte ratio(NLR)(HR=1.800,95%CI=1.313-2.468,P<0.001)were the independent risk factors for prognosis of cervical cancer.The AUC of the nomogram model in the training and validation groups were 0.860 and 0.757,respectively.The calibration curve was well fitted with the 45°diagonal.The prediction results of long-term prognosis of this model were in good agreement with the actual situation.Conclusions Adenocarcinoma,NLR,DKI score and depth of invasion≥1/2 muscular layer are the independent risk factors for the prognosis of patients with cervical cancer.The constructed nomogram model could reliably predict the 3-year survival rate of patients with cervical cancer.
作者
何滨
陈武标
吴永峻
陈晓东
叶玲
He Bin;Chen Wubiao;Wu Yongjun;Chen Xiaodong;Ye Ling(Radiology Imaging Center,the Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2023年第7期606-611,共6页
Chinese Journal of Radiation Oncology
关键词
宫颈肿瘤
弥散峰度成像
预后
列线图
直方图分析
Uterine cervical neoplasms
Diffusion kurtosis imaging
Prognosis
Nomograms
Histogram analysis
