[1]李政晓,李昇霖,薛彩强,等.基于术前增强CT构建列线图模型预测胰腺导管腺癌R0切除[J].中国医学物理学杂志,2022,39(8):957-962.[doi:DOI:10.3969/j.issn.1005-202X.2022.08.007]
　LI Zhengxiao,,et al.Using nomogram model based on preoperative contrast-enhanced CT to predict R0 resection of pancreatic ductal adenocarcinoma[J].Chinese Journal of Medical Physics,2022,39(8):957-962.[doi:DOI:10.3969/j.issn.1005-202X.2022.08.007]
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基于术前增强CT构建列线图模型预测胰腺导管腺癌R0切除()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第8期
页码:
957-962
栏目:
医学影像物理
出版日期:
2022-08-04

文章信息/Info

Title:
Using nomogram model based on preoperative contrast-enhanced CT to predict R0 resection of pancreatic ductal adenocarcinoma
文章编号:
1005-202X（2022）08-0957-06
作者:
李政晓1; 2; 3; 4; 李昇霖1; 2; 3; 4; 薛彩强1; 2; 3; 4; 刘苏卫1; 2; 3; 4; 孙嘉晨1; 2; 3; 4; 任铁柱1; 2; 3; 4; 周俊林1; 2; 3; 4
1.兰州大学第二医院放射科， 甘肃 兰州 730030； 2.兰州大学第二临床医学院， 甘肃 兰州 730030； 3.甘肃省医学影像重点实验室， 甘肃 兰州 730030； 4.医学影像人工智能甘肃省国际科技合作基地， 甘肃 兰州 730030
Author(s):
LI Zhengxiao1;  2;  3;  4;  LI Shenglin1;  2;  3;  4;  XUE Caiqiang1;  2;  3;  4;  LIU Suwei1;  2;  3;  4;  SUN Jiachen1;  2;  3;  4;  REN Tiezhu1;  2;  3;  4;  ZHOU Junlin1;  2;  3;  4
1. Department of Radiology, Lanzhou University Second Hospital, Lanzhou 730030, China 2. The Second Clinical Medical School, Lanzhou University, Lanzhou 730030, China 3. Key Laboratory of Medical Imaging of Gansu Province, Lanzhou 730030, China 4. Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou 730030, China
关键词:
胰腺导管腺癌; R0切除; 增强CT; 列线图模型
Keywords:
Keywords: pancreatic ductal adenocarcinoma R0 resection contrast-enhanced CT nomogram model
分类号:
R318；R445
DOI:
DOI:10.3969/j.issn.1005-202X.2022.08.007
文献标志码:
A
摘要:
目的：探讨术前增强CT扫描特征结合临床特征构建列线图模型预测胰腺导管腺癌（PDAC）是否能达到R0切除。方法：回顾性分析经手术病理证实且进行切缘状态评估的106例PDAC患者的术前增强CT成像资料，依据切缘状态分为R0切除组与R1切除组。分析患者术前CA199、CA125、CEA等临床资料；观测术前增强CT肿瘤部位、肿瘤横径、肿瘤与周围血管的最大夹角（T/动脉夹角、T/门静脉夹角、T/肠系膜上静脉夹角）、瘤周脂肪间隙以及淋巴结转移等特征；随后对两组患者进行单因素、多因素Logistic回归构建列线图模型术前预测PDAC是否能达到R0切除。结果：R0切除组与R1切除组在肿瘤横径、CA199、CA125、CEA、T/动脉夹角、T/门静脉夹角、T/肠系膜上静脉夹角及淋巴结转移的差异有统计学意义（P<0.05）。单因素及多因素Logistic回归分析表明淋巴结转移［OR：0.205（95%CI：0.043~0.972）, P<0.05］、T/动脉夹角［OR：0.085（95%CI：0.017~0.434）, P<0.01］、T/门静脉夹角［OR：0.155（95%CICI：0.031~0.783）, P<0.05］、肿瘤横径［OR：1.073（95%CI：1.004~1.146）, P<0.05］、CA199［OR：1.003（95%CI：1.001~1.005）, P<0.01］是R0切除的独立危险因子。通过多因素Logistic回归构建的模型能有效预测PDAC的R0切除。校准曲线表明列线图模型预测概率能较好拟合实际概率，校准度高。结论：术前较低水平的CA199、较短的肿瘤横径、T/动脉夹角及T/门静脉夹角<180°、非淋巴结转移状态是PDAC的R0切除的独立预测因子，列线图模型能有效预测PDAC是否能达到R0切除。
Abstract:
Abstract: Objective To investigate the value of preoperative enhanced CT scan features combined with clinical features to construct a nomogram model for predicting whether the R0 resection of pancreatic ductal adenocarcinoma (PDAC) can be achieved. Methods The preoperative contrast-enhanced CT imaging data of 106 patients with PDAC who were confirmed by surgery and pathology and whose resection margin status was evaluated were retrospectively analyzed. According to the resection margin status, they were divided into R0 resection group and R1 resection group. The preoperative CA199, CA125, CEA and other clinical data of the patients were analyzed. Before surgery, the tumor location, the transverse diameter of the tumor, the maximum angle between the tumor and the surrounding blood vessels (T/artery angle, T/portal vein angle, T/superior mesenteric vein angle), peritumoral fat space and lymph node metastasis were also observed in preoperative contrast-enhanced CT. Then, univariate and multivariate Logistic regressions were used to construct a nomogram model for the preoperative prediction of whether the R0 resection of PDAC can be achieved. Results There were significant differences between R0 resection group and R1 resection group in the transverse diameter of the tumor, CA199, CA125, CEA, T/artery angle, T/portal vein angle, T/superior mesenteric vein, and lymph node metastasis (P<0.05). Univariate and multivariate Logistic regression analyses showed that lymph node metastasis ［OR: 0.205 (95%CI: 0.043-0.972), P<0.05］, T/artery angle ［OR: 0.085 (95%CI: 0.017-0.434), P<0.01］, T/portal vein angle ［OR: 0.155 (95%CI: 0.031-0.783), P<0.05］, the transverse diameter of the tumor ［OR: 1.073 (95%CI: 1.004-1.146), P<0.05］, CA199 ［OR: 1.003 (95%CI: 1.001-1.005), P<0.01］ were independent risk factors for R0 resection. The model constructed by multivariate Logistic regression could effectively predict the R0 resection of PDAC. The calibration curve revealed that the predicted probability of the nomogram model could better fit the actual probability, with high calibration. Conclusion Preoperative lower level of CA199, shorter transverse diameter of the tumor, T/artery angle and T/portal vein angle <180°, and non-lymph node metastasis were independent predictors of the R0 resection of PDAC, and the nomogram model can effectively predict whether the R0 resection of PDAC can be achieved.

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备注/Memo

备注/Memo:
【收稿日期】2022-03-21 【基金项目】国家自然科学基金（82071872）；甘肃省科技计划项目（21YF5FA123） 【作者简介】李政晓，硕士研究生，研究方向：中枢及腹部影像学，E-mail: 1825416991@qq.com 【通信作者】周俊林，博士，主任医师，研究方向：神经影像学，E-mail: lzuzjl601@163.com
更新日期/Last Update: 2022-09-05