| 徐园园,郑吟诗,李依明,等.CT增强扫描灰度直方图纹理分析技术对结直肠癌术前恶性程度评估及预后的预测价值[J].安徽医药,2024,28(10):1961-1967. |
| CT增强扫描灰度直方图纹理分析技术对结直肠癌术前恶性程度评估及预后的预测价值 |
| The value of gray histogram texture analysis technique of enhanced CT scanning in preoperative evaluation of malignant degree and prognosis of colorectal cancer |
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| DOI：10.3969/j.issn.1009-6469.2024.10.012 |
| 中文关键词: 结直肠肿瘤 CT增强扫描 灰度直方图 纹理分析 评估 测病，在明， |
| 英文关键词: Colorectal neoplasms CT contrasten hancement Grey hidtogram Texture analysis Assess |
| 基金项目: |
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| 中文摘要: |
| 目的探究 CT增强扫描灰度直方图纹理分析技术对结直肠癌(CRC)术前恶性程度评估及对预后的预测价值。方法选取 2018年 2月至 2021年 2月于商丘市第一人民医院就诊经术后病理证实的 94例 CRC病人为研究对象，其中高分化 28例、中分化组 32例和低分化组 34例。统计分析所有病人腹部动脉期 CT增强扫描灰度直方图纹理分析特征参数，并采用受试者操作特征曲线(ROC曲线)分析特征参数对 CRC病人术前恶性程度的诊断效能及预后的预测价值。采用多因素 Cox回归分析筛选影响 CRC病人预后不良的因素，构建列线图预测模型并进行评价。结果 CT增强扫描灰度直方图均值、峰度、 10%分位、 50%分位在高、中、低分化三组中差异有统计学意义(142.39±21.78比 130.62±18.79比 122.34±14.57，0.51±0.14比 0.89±0.24比 1.11±0.31，129.63±27.42比 113.75±22.13比 102.64±17.85，145.51±20.39比 134.52±17.34比 126.09±14.53)(P<0.05)。评估 CRC恶性程度时，上述指标均具有诊断效能，且联合诊断效能最佳。低分化、淋巴结转移、中性粒细胞与淋巴细胞比值( NLR)、血小板与淋巴细胞比值(PLR)是 CRC病人预后不良的危险因素，而均值、 10%分位、 50%分位是其保护因素(P<0.05)。均值、 10%分位、 50%分位联合预测病人预后的曲线下面积(AUC)为 0.83［95%CI:(0.76，0.91)］远大于各指标单独预测的 AUC值。利用上述指标构建列线图模型，经内部验证(Bootstrap重采样 1 000次)后可知，该模型预人 CRC病人预后不良 AUC为 0.84［95%CI:(0.71，0.92)］灵敏度为 82.7%，特异度为 75.6%。结论腹部动脉期 CT增强扫描灰度直方图纹理分析特征参数在不同恶性程度 CRC之间存显差异，可用于评估 CRC病人术前恶性程度及预测预后，为临床 CRC病人术前评估及预后提供了新的可能。 |
| 英文摘要: |
| Objective To explore the value of enhanced CT histogram texture analysis in evaluating preoperative malignancy degreeand predicting prognosis of colorectal cancer (CRC).Methods A total of 94 patients with CRC who were treated in the First People'sHospital of Shangqiu City from February 2018 to February 2021 and confirmed by postoperative pathology were selected as the studyobjects, including 28 patients in the highly differentiated group, 32 patients in the moderately differentiated group and 34 patients inthe poorly differentiated group. The feature parameters of the gray histogram of enhanced CT scanning in abdominal arterial phase wereanalyzed statistically, and the predictive value of characteristic parameters on preoperative malignant degree diagnosis and prognosis ofCRC patients was analyzed by receiver operating characteristic curve (ROC curve). Multivariate Cox regression analysis was used toscreen the factors affecting the poor prognosis of CRC patients, and a nomogram prediction model was constructed and evaluated.Re? sults There were significant differences in mean value, kurtosis, 10% quantile and 50% quantile among high, medium and low differentiation groups (142.39±21.78 vs. 130.62±18.79 vs. 122.34±14.57, 0.51±0.14 vs. 0.89±0.24 vs. 1.11±0.31, 129.63±27.42 vs. 113.75±22.13 vs. 102.64±17.85, 145.51±20.39 vs. 134.52±17.34 vs. 126.09±14.53, P<0.05). When evaluating the degree of CRC malignancy,the four indicators had certain diagnostic efficacy, and the combined diagnostic efficacy was the best. Low differentiation, lymph nodemetastasis, neutrophil/lymphocyte ratio (NLR) and platelet-to-lymphoccyte ratio (PLR) were independent risk factors for poor prognosisin CRC patients, while mean, 10% and 50% were protective factors (P<0.05). The area under the curve (AUC) of the mean, 10% quantile and 50% quantile combined to predict the prognosis of patients was 0.83[95%CI:(0.76,0.91)], which was much higher than the AUCvalue predicted by each index alone. The above indexes were used to construct a line chart model. After internal verification (Bootstrapresampling 1 000 times), it could be seen that the area under curve (AUC) of this model for predicting poor prognosis of CRC patients was 0.84[95%CI:(0.71,0.92)]. The sensitivity and specificity were 82.7% and 75.6%, respectively.Conclusions The feature parameters of gray histogram texture analysis of CT enhanced scanning are significantly different among different degrees of malignancy, whichcan be used to evaluate the preoperative malignancy and predict the prognosis of CRC patients, providing a new possibility for preoperative evaluation and prognosis of clinical CRC patients. |
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