ISSN 1004-4140
    CN 11-3017/P

    CT定量参数预测浸润性肺腺癌气道播散的价值

    Predictive Values of Quantitative Computed Tomography Parameters for Spread Through Air Spaces in Patients with Invasive Lung Adenocarcinoma

    • 摘要: 目的:探索CT定量参数对浸润性肺腺癌气道播散(STAS)的预测价值。方法:回顾性收集2020年9月至2023年6月南京医科大学附属苏州医院病理证实为浸润性肺腺癌的临床及CT影像资料,基于推想人工智能软件获取病灶定量参数,对比STAS阳性及阴性组间CT定量参数的差异。对有统计学意义的参数采用受试者操作特征曲线(ROC)分析及共线性检验筛选后建立浸润性肺腺癌STAS的CT定量参数预测模型。结果:纳入浸润性肺腺癌共148例,其中STAS阳性46例,阴性102例,两组间浸润性肺腺癌病灶的CT值中位数、平均CT值、实性占比、最小CT值、质量、轴位长径、轴位短径、轴位平均径、轴位最大层面面积、最大CT值、三维长径、表面积、体积、CT值标准差、距胸膜距离、紧凑度、球形度、峰度、偏度等参数差异均有统计学意义,其AUC分别为0.941、0.937、0.936、0.926、0.839、0.817、0.799、0.815、0.796、0.795、0.789、0.784、0.775、0.373、0.351、0.313、0.312、0.215和0.149;二元logistic分析显示病灶的实性占比、偏度为浸润性肺腺癌STAS的独立危险因素,其联合AUC为0.943。结论:CT定量参数对浸润性肺腺癌STAS具有较好的预测价值,其中病灶实性占比、偏度为预测浸润性肺腺癌STAS的独立危险因素。

       

      Abstract: Objective: This study aimed to predict spread through air spaces (STAS) in patients with invasive lung adenocarcinoma based on quantitative computed tomography (CT) parameters. Methods: The clinical and CT data of patients with invasive lung adenocarcinoma confirmed by surgical pathology at the Affiliated Suzhou Hospital of Nanjing Medical University between September 2020 and June 2023 were retrospectively collected. The quantitative parameters of invasive lung adenocarcinoma were obtained using the InferRead CT Lung 4.0 artificial intelligence software. The quantitative CT parameters of the STAS-positive and negative groups were compared. The parameters with significantly different values for both groups were evaluated for diagnostic performance using the area under the receiver operating characteristic curve and assessed for collinearity. A quantitative CT parameter prediction model for STAS in patients with invasive lung adenocarcinoma was established. Results: A total of 148 patients with invasive lung adenocarcinoma were included. Forty-six of them had STAS, while 102 did not. Significant differences were observed in the following parameters between the two groups: median CT value, mean CT value, proportion of solid components, minimum CT value, mass, axial maximum diameter, axial minimum diameter, axial mean diameter, axial maximum area, maximum CT value, 3D long diameter, surface area, volume, standard deviation of CT value, distance from pleura, compactness, sphericity, kurtosis, and skewness. The AUC values for these parameters were 0.941, 0.937, 0.936, 0.926, 0.839, 0.817, 0.799, 0.815, 0.796, 0.795, 0.789, 0.784, 0.775, 0.373, 0.351, 0.313, 0.312, 0.215, and 0.149, respectively. Binary logistic regression revealed the proportions of solid components and skewness as independent predictors of STAS (all P< 0.05). Their combined area under the curve was 0.943. Conclusion: Quantitative CT parameters have significant predictive values for STAS in patients with invasive lung adenocarcinoma. The consolidation tumor ratio and skewness are independent risk factors of STAS.

       

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