| .基于临床病理特征、动态对比增强MRI参数构建结直肠癌微卫星
不稳定Nomogram预测模型与验证[J].,2024,(24):4749-4752 |
| 基于临床病理特征、动态对比增强MRI参数构建结直肠癌微卫星
不稳定Nomogram预测模型与验证 |
| Construction Model and Validation of Microsatellite Instability Nomogramin Colorectal Cancer Based on Clinicopathological Featuresand Dynamic Contrast-Enhanced MRI Parameters |
| 投稿时间：2024-08-21 修订日期：2024-09-23 |
| DOI：10.13241/j.cnki.pmb.2024.24.036 |
| 中文关键词: 结直肠癌 动态对比增强核磁共振成像参数 病理特征 微卫星不稳定 列线图预测模型 |
| 英文关键词: Colorectal cancer Dynamic contrast-enhanced magnetic resonance imaging parameters Clinicopathological features Microsatellite instability Nomogram prediction model |
| 基金项目:河北省医学科学研究计划项目（20201327） |
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| 中文摘要: |
| 摘要 目的：探讨基于临床病理特征、动态对比增强核磁共振成像（MRI）参数构建的列线图（Nomogram）预测模型对结直肠癌（CRC）微卫星不稳定的预测价值。方法：335例CRC患者术前均行动态对比增强MRI检查，根据检测结果将其分为微卫星稳定组（n=243）和微卫星不稳定组（n=92）。采用单因素和多因素Logistic回归分析CRC患者微卫星不稳定的影响因素；并构建CRC患者微卫星不稳定Nomogram预测模型。采用受试者工作特征（ROC）曲线评价Nomogram预测模型对CRC患者微卫星不稳定的预测效能。结果：微卫星不稳定组容积转运常数（Ktrans）、速率常数（Kep）、初始强化曲线下面积（iAUC）均低于微卫星稳定组，微卫星不稳定组中/低分化比例、有癌结节比例、发生淋巴结转移比例均高于微卫星稳定组（P＜0.05）。Ktrans、Kep、iAUC均升高是CRC患者微卫星不稳定的保护因素，中/低分化、有癌结节、发生淋巴结转移是CRC患者微卫星不稳定的危险因素（P＜0.05）。Nomogram预测模型的预测曲线与理想曲线贴合度良好，ROC曲线分析结果显示，该模型预测CRC患者微卫星不稳定的曲线下面积（AUC）为0.938。结论：Ktrans、Kep、iAUC均升高是CRC患者微卫星不稳定的保护因素，中/低分化、有癌结节、发生淋巴结转移是CRC患者微卫星不稳定的危险因素，基于上述影响因素构建的Nomogram预测模型对CRC患者微卫星不稳定具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the predictive value of nomogram (Nomogram) prediction model based on clinicopathological features and dynamic contrast-enhanced magnetic resonance imaging (MRI) parameters for microsatellite instability in colorectal cancer (CRC). Methods: 335 CRC patients underwent dynamic contrast-enhanced MRI before operation, who were divided into microsatellite stable group (n=243) and microsatellite unstable group (n=92) according to the test results. The influencing factors of microsatellite instability in CRC patients were analyzed by univariate and multivariate Logistic regression analysis. Nomogram prediction model of microsatellite instability in CRC patients was constructed. The predictive efficacy of the Nomogram prediction model for microsatellite instability in CRC patients were evaluated by receiver operating characteristic (ROC) curve. Results: The volume transfer constant (Ktrans), rate constant (Kep) and area under the initial enhancement curve (iAUC) in microsatellite instability group were lower than those in microsatellite stability group, the proportion of moderate/low differentiation, cancer nodules and lymph node metastasis in microsatellite instability group were higher than those in microsatellite stability group (P<0.05). Elevated Ktrans, Kep, and iAUC were protective factors for microsatellite instability in CRC patients, moderate/low differentiation, cancer nodules, and lymph node metastasis were risk factors for microsatellite instability in CRC patients (P<0.05). The prediction curve of the Nomogram prediction model was in good agreement with the ideal curve, ROC curve analysis showed that, the area under the curve (AUC) of the model for predicting microsatellite instability in CRC patients was 0.938. Conclusion: The increase of Ktrans, Kep and iAUC are all protective factor for microsatellite instability in CRC patients, moderate/low differentiation, cancer nodules and lymph node metastasis are risk factors for microsatellite instability in CRC patients, the Nomogram prediction model based on the above influencing factors has a high predictive value for microsatellite instability in CRC patients. |
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