MRI评估细胞外容积分数对老年鼻咽癌患者淋巴结转移的预测价值 ^*

MRI evaluation of extracellular volume fraction in predicting lymph node metastasis in elderly patients with nasopharyngeal carcinoma

摘要

目的 探讨MRI评估细胞外容积分数(ECV)对老年鼻咽癌患者淋巴结转移的预测价值。方法 选取2022年7月—2024年2月中国人民解放军联勤保障部队第九○四医院及海军军医大学第一附属医院收治的老年鼻咽癌患者121例进行回顾性分析。依据术后病理检查结果分为淋巴结转移组(36例)和无淋巴结转移组(85例)。患者均接受了MRI检查,并计算ECV。采用多因素logistic回归模型分析淋巴结转移的影响因素,采用ROC曲线分析ECV对淋巴结转移的预测价值。结果 淋巴结转移组TNM分期Ⅲ期占比、分化程度低分化占比以及ECV水平均高于无淋巴结转移组(P<0.05)。多因素logistic回归分析显示,分化程度低分化、高ECV均为老年鼻咽癌患者淋巴结转移的独立影响因素(P<0.05)。ROC曲线分析显示,ECV对淋巴结转移的预测效能较高,AUC为0.877(95%CI:0.806~0.948,P<0.001),cut-off值为21.21%,灵敏度为0.722,特异度为0.953,约登指数为0.675。结论 MRI评估ECV在老年鼻咽癌患者淋巴结转移的预测中具有重要价值,ECV可作为有效的临床参考指标。

Abstract

Objective To investigate the predictive value of MRI for evaluating extracellular volume fraction (ECV) for lymph node metastasis in elderly nasopharyngeal carcinoma patients. Methods A total of 121 elderly nasopharyngeal carcinoma patients admitted to No. 904 Joint Logistical Support Force Hospital of PLA and the First Affiliated Hospital of Naval Military Medical University from July 2022 to February 2024 were retrospectively analyzed. According to the results of postoperative pathological examination, the patients were divided into a lymph node metastasis group (36 cases) and a no lymph node metastasis group (85 cases). All patients underwent MRI and ECV was calculated. Multivariate logistic regression model was used to analyze the influencing factors of lymph node metastasis. ROC curve was used to analyze the predictive value of ECV for lymph node metastasis. Results The TNM stage Ⅲ proportion, low differentiation proportion and ECV level in lymph node metastasis group were higher than those in no lymph node metastasis group (P < 0.05). Multivariate logistic regression analysis showed TNM stage Ⅲ, low differentiation, high ECV were influential factors for lymph node metastasis (P < 0.05). ROC curve analysis showed that ECV had a high predictive efficacy for lymph node metastasis, with an AUC of 0.877 (95% CI: 0.806 to 0.948, P<0.001), a cut-off value of 21.21%, a sensitivity of 0.722, a specificity of 0.953, and a Youden index of 0.675. Conclusion ECV assessed by MRI is of great value in predicting lymph node metastasis in elderly nasopharyngeal carcinoma patients, and ECV can be used as an effective clinical reference index.

关键词

鼻咽癌 / 细胞外容积分数 / 淋巴结转移

Key words

Nasopharyngeal carcinoma / Extracellular volume fraction / Lymph node metastasis

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基金资助

^*江苏省自然科学基金(BK20221272)