基于CT影像组学预测甲状腺乳头状癌甲状腺外侵犯的价值OACSTPCD

Objective:To evaluate the value of CT-based radiomics in predicting extrathyroidal extension(ETE)of papillary thyroid cancer(PTC).Methods:140 patients with PTC were selected as the study subjects who were admitted to our hospital from October 2021 to October 2022.The patients were randomly divided into training set(n=98)and test set(n=42)at a ratio of 7:3.According to whether there was ETE,the patients were divided into ETE group(n=55)and non-ETE group(n=43).Based on CT imaging omics scores and multiple logistic regression models,the key factors affecting the occurrence of ETE in PTC patients were analyzed.The variables included in the model were based on the results of univariate analysis,and used stepwise regression method for variable screening.The goodness of fit of the model was evaluated through the Hosmer-Lemeshow goodness of fit test.The ROC curve was used to evaluate the model's discriminative ability,while the calibration curve was used to evaluate the model's predictive accuracy.Results:There were significant differences between the two groups in tumor border,age,maximum tumor diameter,multifocal,central lymph node metastasis,cervical lymph node metastasis,Hashimoto's thyroiditis(P＜0.05).Multiple Logistic regression model showed that maximum tumor diameter,age,multiple foci,cervical lymph node metastasis,plain scan Rad score and enhanced scan Rad score were independent risk factors for the occurrence of ETE in PTC patients.And based on the CT imaging score and clinical risk factors,a nomogram prediction model was constructed.The results of ROC curve and calibration curve showed that the prediction model had good discrimination and accuracy.The AUC values of the training set(AUC=0.962)and the test set(AUC=0.937)were both close to 1,indicating that the predictive model had good discriminative ability and could accurately distinguished PTC patients with and without ETE.This provided important reference for clinical doctors in formulating treatment plans and evaluaed patient prognosis.Conclusion:Based on CT radiomics,clinical physicians can better predict the risk of ETE in PTC patients aged ≥ 55 years,with a maximum tumor diameter＞2.0 cm,accompanied by multiple lesions and cervical lymph node metastasis,which can provide a reference basis for clinicians to choose preoperative surgical methods.