中国癌症杂志2025，Vol.35Issue(7)：695-701,7.DOI:10.19401/j.cnki.1007-3639.2025.07.008
基于血管移位的诊断评分和诺莫图在鉴别颈部迷走神经鞘瘤和颈部交感神经鞘瘤中的应用
Preoperative differentiation of vagal nerve cervical schwannomas from sympathetic chain cervical schwannomas based on diagnosis score and vascular displacement nomogram
向诗语 1李桥 1沈长青 1顾雅佳 1吴斌2
作者信息
- 1. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海 200032
- 2. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海 200032||上海市质子重离子医院放射诊断科,上海 201315||上海市放射肿瘤学重点实验室,上海 201321||上海质子重离子放射治疗工程技术研究中心,上海 201321
- 折叠
摘要
Abstract
Background and purpose:Accurate preoperative differentiation between vagal nerve cervical schwannomas(SCCS)and sympathetic chain cervical schwannomas(SCCS)in the neck is crucial because of their different postoperative complication.This study aimed to construct and validate a Diagnosis Score and vascular displacement nomogram for the preoperative differentiation of VNCS from SCCS in the neck.Methods:This cross-sectional study retrospectively analyzed patients with pathologically confirmed VNCS and SCCS at Fudan University Shanghai Cancer Center from January 2017 to April 2022.This study was approved by the medical ethics committee of Fudan University Shanghai Cancer Center(approval number:1612167-18).Inclusion criteria:① histopathological diagnosis of VNCS or SCCS through biopsy or surgical resection;② patients with complete clinic data;③availability of preoperative contrast-enhanced computed tomography(CT)or magnetic resonance imaging(MRI)examinations.Patients were excluded for:① contrast agent contraindications;② poor image quality;③ severe artifacts;④ non-standard scanning protocols.The cohort was randomly divided into training and validation sets in a 7∶3 ratio.Two radiologists(one resident and one attending physician)independently evaluated tumor characteristics(location,size and vascular displacement patterns)on preoperative imaging.Independent predictors were selected using LASSO regression analysis to construct a diagnostic scoring system and nomogram,with model performance evaluated by the receiver operating characteristic(ROC)curve.Results:A total of 110 patients were enrolled,with 77 cases allocated to the training set and 33 cases to the validation set.The age range was 24-78 years,and the mean age was(51.22±12.36)years.There were no statistically significant differences in baseline characteristics including age,gender,tumor location and size between the two patient groups(P＞0.05).ICA/ECA splaying was significantly associated with SCCS(P＜0.001),while the ICA/IJV splaying was significantly associated with VNCS(P＜0.001).Lateral and posterior ICA displacement were significantly associated with SCCS(P＜0.001),and medial and anterior ICA displacement were significantly associated with VNCS(P＜0.001).Five features including tumor size,ICA displacement direction,IJV displacement direction,ICA/ECA splaying and ICA/IJV splaying were used to establish the Diagnosis Score and nomogram.The nomogram combined imaging features showed favorable preference value for differentiating VNCS from SCCS,with area under curve(AUC)values of 0.953(95%CI:0.912-0.994)and 0.939(95%CI:0.885-0.993)for the training and validation cohorts,respectively.Conclusion:The Diagnosis Score and vascular displacement nomogram showed favorable predictive efficacy for differentiating VNCS from SCCS in the neck,and might be useful for clinical decision-making.关键词
颈部迷走神经鞘瘤/颈部交感神经鞘瘤/血管移位/诊断评分/诺莫图/横断面研究Key words
Vagal nerve cervical schwannomas/Sympathetic chain cervical schwannomas/Vascular displacement/Diagnosis score/Nomogram/Cross-sectional study分类
医药卫生引用本文复制引用
向诗语,李桥,沈长青,顾雅佳,吴斌..基于血管移位的诊断评分和诺莫图在鉴别颈部迷走神经鞘瘤和颈部交感神经鞘瘤中的应用[J].中国癌症杂志,2025,35(7):695-701,7.
