摘要
目的探讨基于增强CT图像的纹理分析对胃癌患者区域淋巴结转移的评估价值。方法收集174例病理确诊为胃癌并行胃癌根治术患者的临床资料。将所有患者依据术后病理结果分为非淋巴结转移组49例和淋巴结转移组125例。采用CT Kinetics纹理分析软件提取两组患者腹部增强CT图像胃癌原发灶的8个纹理特征参数(平均值A、偏度A、峰度A、熵A、平均值V、偏度V、峰度V、熵V)并进行比较,绘制ROC曲线分析胃癌原发灶CT纹理特征参数对区域淋巴结转移的评估效能。结果淋巴结转移组与非淋巴结转移组胃癌原发灶的熵A、熵V比较差异具有显著性(t=-5.592、-5.557,P<0.05),而平均值A、偏度A、峰度A、平均值V、偏度V、峰度V两组间比较均无显著差异(P>0.05)。熵A、熵V评估胃癌患者区域淋巴结转移的ROC曲线下面积(AUC)分别为0.751、0.754,截断值分别为9.47、9.84,灵敏度分别为74.4%、56.8%,特异度分别为69.4%、85.7%。结论基于增强CT图像的胃癌原发灶纹理分析对区域淋巴结性质有一定的评估价值,其纹理特征参数熵A、熵V升高,提示肿瘤异质性更高,发生区域淋巴结转移的可能性更高。
Objective To investigate the value of texture analysis based on contrast-enhanced CT images in assessing regional lymph node metastasis in patients with gastric cancer.Methods Clinical data were collected from 174 patients with pathologically confirmed gastric cancer who underwent radical gastrectomy,and according to postoperative pathological results,the patients were divided into non-lymph node metastasis group with 49 patients and lymph node metastasis group with 125 patients.The CT Kinetics texture analysis software was used to extract 8 texture features(Mean value-A,Skewness-A,Kurtosis-A,Entropy-A,Mean value-V,Skewness-V,Kurtosis-V,and Entropy-V)of primary gastric cancer lesions,which were compared between the two groups.The receiver operating characteristic(ROC)curve were plotted to analyze the performance of CT texture features of primary gastric cancer lesions in assessing regional lymph node metastasis.Results There were significant differences in Entropy-A and Entropy-V of primary gastric cancer lesions between the lymph node metastasis group and the non-lymph node metastasis group(t=-5.592,-5.557,P<0.05),while there were no significant differences between the two groups in Mean value-A,Skewness-A,Kurtosis-A,Mean value-V,Skewness-V,and Kurtosis-V(P>0.05).Entropy-A and Entropy-V had an area under the ROC curve(AUC)of 0.751 and 0.754,respectively,in assessing regional lymph node metastasis in patients with gastric can-cer,with a cut-off value of 9.47 and 9.84,respectively,a sensitivity of 74.4%and 56.8%,respectively,and a specificity of 69.4%and 85.7%,respectively.Conclusion The texture analysis of primary gastric cancer lesions based on contrast-enhanced CT images has a certain value in assessing regional lymph node metastasis,and increases in the texture parameters Entropy-A and Entropy-V may indicate greater tumor heterogeneity and a higher probability of regional lymph node metastasis.
作者
熊瑶
李天然
郭玉林
XIONG Yao;LI Tianran;GUO Yulin(Department of Radiology,The Fourth Medical Center of PLA General Hospital,Beijing 100142,China)
出处
《精准医学杂志》
2026年第1期46-49,共4页
Journal of Precision Medicine
关键词
胃肿瘤
淋巴转移
体层摄影术
X线计算机
图像处理
计算机辅助
纹理分析
Stomach neoplasms
Lymphatic metastasis
Tomography,X-ray computed
Image processing,computer-assisted
Texture analysis
