基于CT特征模型在评估胃癌组织分化程度中的应用

A CT Features-based Model for Predicting Histological Grade of Gastric Cancer

目的 探讨基于CT特征模型评估胃癌组织分化程度的应用价值。方法回顾性收集273例胃癌患者临床病理及CT影像资料并分为低分化组和中高分化组。比较两组间CT特征差异。利用单因素和多因素分析筛选胃癌组织分化程度危险因素。采用受试者工作特征曲线评估模型的预测效能。结果年龄、位置、静脉期CT值、动脉期强化率、动脉期强化程度、T分期、N分期、脉管浸润在低分化胃癌与中高分化胃癌组间的差异均具有统计学意义(P均<0.05)。年龄、位置、T分期、静脉期CT值、动脉期强化率是胃癌组织分化程度的独立危险因子。在验证集中,基于所有参数联合模型的曲线下面积高于基于联合位胃和T分期的定性模型(0.787 vs.0.720)和基于联合年龄、静脉期CT值、动脉期强化率的定量模型(0.787 vs.0.759)。结论患者年龄、位置、T分期、静脉期CT值、动脉期强化率是胃癌组织分化程度危险因子,基于上述特征联合模型能够较好预测胃癌组织分化程度。

Mective To explore the application value of a CT features-based model in predicting the histological grade of gastric cancer.Methods We retrospectively collected clinicopathological and CT imaging data from 273 patients with gastric cancer to compare the differences in CT features between the poorly differentiated group and moderately/well differentiated group.Univariate and multivariate analysis was conducted to determine the risk factors for gastric cancer differentiation.We evaluated the predictive efficacy of the model using the receiver operating chara cteristic cu rve.Results The re are statistically significa nt differences in the age,tumor location,CT value in venous phase images,arterial phase enhancement rate,arterial phase enhancement degree,T stage,N stage,and lymphovascular invasion between two groups(P<0.05).The age,location,T stage,CT value in venous phase images,and arterial phase enhancement rate were identified as risk factors for gastric cancer differentiation.In the testing set,the joint model that used all these risk factors had a higher AUC than the qualitative model combined with location and T stage(0.787 vs.0.720) and the quantitative model combined with age,CT value in venous phase images and a rterial phase enhancement rate(0.787 vs.0.759).Conclusion The age,location,T stage,CT value in venous phase images,and arterial phase enhancement rate were all risk factors for gastric cancer differentiation.The joint model that used all these risk factors ca n effectively predict the histological grade of gast ric cancer.