临床误诊误治2025，Vol.38Issue(4)：31-36,93,7.DOI:10.3969/j.issn.1002-3429.2025.04.007
含血清标志物-CT影像组学列线图模型诊断非小细胞肺癌患者纵隔淋巴结转移的价值
Diagnostic Value of Serum Marker-CT Radiomics Nomogram Model for Mediastinal Lymph Node Metastases in Patients with Non-small Cell Lung Cancer
摘要
Abstract
Objective To explore the diagnostic value of serum marker-CT radiomics nomogram model for mediastinal lymph node metastases(MLNM)in patients with non-small cell lung cancer(NSCLC).Methods A total of 163 NSCLC pa-tients treated from January 2021 to December 2023 were selected as the training set and divided into MLNM group and non-MLNM group according to postoperative pathology.Another 43 NSCLC patients treated from January to April 2024 were select-ed as the validation set.The general data,serum markers and CT images in the training set were recorded.Double-Z software was used to extract the radiomics features,and Lasso algorithm was used to screen the optimal feature subset.The influencing factors of MLNM in NSCLC patients were analyzed by multivariate logistic regression.The serum marker-CT radiomics nomo-gram model was constructed,and the diagnostic efficiency of this nomogram model in the training set and validation set was an-alyzed by drawing the receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results Carcino-embryonic antigen(CEA),carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),CT ra-diomics score,the proportion of tumor stage III and smoking history in MLNM group were higher than those in non-MLNM group(P＜0.05).CEA,CA125,CYFRA21-1,tumor stage,smoking history and CT radiomics score were independent risk factors for MLNM in NSCLC patients(P＜0.05).In the training set and validation set,the area under the ROC curve of the serum marker-CT radiomics nomogram model for diagnosing MLNM in NSCLC patients was 0.835 and 0.891,respectively.The diagnosis results were highly consistent with the actual results,and the net return rate was the highest in the range of 0.1-0.7 and 0.0-0.8.Conclusion The diagnosis of MLNM in NSCLC patients with serum marker-CT radiomics nomogram model has high efficacy and strong clinical practicability,which is helpful to guide clinical diagnosis and treatment.关键词
非小细胞肺癌/纵隔淋巴结转移/癌胚抗原/糖类抗原125/影像组学/列线图模型Key words
Non-small cell lung cancer/Mediastinal lymph node metastasis/Carcinoembryonic antigen/Carbohy-drate antigen125/Radiomics/Nomogram model分类
医药卫生引用本文复制引用
孙源源,吕泳西,程志杰,万正国,张浩,刘彭华..含血清标志物-CT影像组学列线图模型诊断非小细胞肺癌患者纵隔淋巴结转移的价值[J].临床误诊误治,2025,38(4):31-36,93,7.基金项目
河北省医学科学重点研究课题计划项目(20240437) （20240437）
