基于术前DCE-MRI特征的肝癌患者术后MVI风险模型效能分析
DOI:
作者:
作者单位:

作者简介:

通讯作者:

基金项目:

河北省医学科学研究课题(20220527)


Efficacy analysis of postoperative MVI risk model in hepatocellular carcinoma patients based on preoperative DCE-MRI features
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    摘要:

    目的 探讨基于术前动态对比增强MRI(DCE-MRI)特征建立的风险模型在早期预测肝细胞癌存在微血管侵犯(MVI)效能。方法 纳入我院在2020年1月—2022年4月收治的接受手术治疗的肝细胞肝癌(HCC)患者242例,收集患者临床实验室资料,于术前2周对所有患者进行DCE-MRI扫描,分析患者DCE-MRI的定量指标和定性指标。术后根据HCC是否存在微血管侵犯分为MVI组和对照组,对比两组患者临床实验室资料,分析影响HCC出现MVI的因素;将所有患者按7∶3比例分为训练集170例和测试集72例,基于训练集的数据采用R软件建立列线图模型,在测试集中验证模型效能。结果 训练集170例患者中共出现70例MVI,据此分组后对比两组临床资料显示,MVsI组Ktrans、Kep、Ve、Vp指标明显高于对照组,MVI组肿瘤边缘不规则、肝胆期瘤周低信号比例高于对照组(P<0.05);多因素Logistics回归分析显示,Ktrans、Ve、Kep、Vp、肿瘤边缘不规则、肝胆期瘤周低信号是HCC出现MVI的独立相关因素(P<0.05);通过构建列线图预测模型,结果显示模型预测HCC出现MIV风险的一致性指数(C-index)为0.948。外部验证显示敏感性为88.00%,特异性为96.36%。结论 Ktrans、Ve、Kep、Vp、肿瘤边缘不规则、肝胆期瘤周低信号是HCC存在MVI的独立相关因素;基于术前DCE-MRI特征建立的风险模型在早期预测HCC出现MVI方面具有良好的预测效能。

    Abstract:

    Objective To investigate the risk model based on preoperative dynamic contrast enhancement MRI (DCE-MRI) characteristics to predict the presence of microvascular invasion in hepatocellular carcinoma at an early stage.Methods A total of 242 HCC patients undergoing surgical treatment admitted to our hospital from January 2020 to April 2022 were included. Clinical laboratory data of patients were collected. DCE-MRI scans were performed on all patients 2 weeks before surgery. The quantitative and qualitative indicators of dynamic contrast-enhanced MRI were analyzed. HCC was divided into MVI group and control group according to the presence or absence of microvascular invasion. The clinical laboratory data of the two groups were compared. The factors influencing MVI in HCC were analyzed. All patients were divided into the training set (170 cases) and the test set (72 cases) according to the ratio of 7〖DK〗∶3. Based on the data of training set, R software was used to build a nomogram model, and the effectiveness of the model was verified in the test set.Results A total of 70 MVI cases occurred in 170 patients in the training set. After grouping and comparing the clinical data of the two groups, the indexes of Ktrans,Kep, Ve and Vp in MVsI group were significantly higher than those in control group. The proportion of irregular tumor margin and low tumor signal in hepatobiliary stage in MVI group was higher than that in control group (P<0.05). Multi-factor Logistics regression analysis showed that Ktrans,Ve,Kep, Vp, irregular tumor margin and low peritumbal signal in hepatobiliary stage were independent correlated factors with MVI in HCC (P<0.05). By constructing a nomogram prediction model, the results showed that the consistency index (C-index) of the model in predicting the risk of MIV in HCC was 0.948. External validation showed that the sensitivity was 88.00% and the specificity was 96.36%.Conclusion Ktrans, Ve, Kep, Vp, irregular tumor margins, and low perihepatobiliary tumor signal are independent factors related to the presence of MVI in HCC. The risk model based on preoperative DCE-MRI characteristics has good predictive efficacy in predicting MVI in HCC at an early stage.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2023-09-18
您是第位访问者
网站版权所有:《西部医学》编辑部     蜀ICP备18038379号-4
地址:四川省成都市武侯区小天竺街75号财富国际18F-1号    邮政编码:610041
电话:028-85570072/85588403 本网站支持 IPv6    E-mail:xbyxqk@163.com
技术支持:北京勤云科技发展有限公司