薄层CT联合临床特征列线图鉴别不同腮腺肿瘤的应用价值

【摘要】 目的 探讨薄层CT联合临床特征列线图在鉴别腮腺多形性腺瘤（PA）和单发腺淋巴瘤（s-AL）的价值。方法 回顾性分经本院病理学诊断为PA的患者99例和s-AL的患者94例，随机分为训练集（135例，其中69例PA,66例s-AL）和测试集（58例，其中30例PA,28例s-AL）。评估所有患者的薄层CT图像特征和临床特征。采用多因素Logistic回归分析筛选临床独立预测因素，并构建列线图。采用受试者工作特征曲线（ROC）的曲线下面积（AUC）评价列线图鉴别PA和s-AL的诊断效能。采用校准曲线分析模型的拟合度，决策曲线分析（DCA）评价模型的临床收益。结果 年龄、性别及病灶CT值是鉴别PA和s-AL的临床独立预测因素。列线图对PA和s-AL的鉴别诊断效能在训练集AUC值为0.958，测试集AUC值为0.906，预测效能较好。校准曲线和DCA曲线显示列线图模型预测结果与实际结果的一致性好，且其临床获益较高。结论 薄层CT联合临床特征构建列线图对PA和s-AL具有较好的鉴别能力，能够为临床决策提供一定参考价值。更多还原

【Abstract】 Objective To explore the value of thin-layer CT combined with clinical features nomogram in differentiating pleomorphic adenoma(PA)from solitary adenolymphoma(s-AL)of the parotid gland.Methods A retrospective analysis was conducted on 99 cases of PA and 94 cases of s-AL diagnosed pathologically at the First Affiliated Hospital of Wannan Medical College.These cases were randomly divided into a training set(135cases,including 69 PA and 66 s-AL)and a test set(58 cases,including 30 PA and 28 s-AL).The thin-layer CT image features and clinical characteristics of all patients were assessed.Multifactorial Logistic regression analysis was used to screen for independent clinical predictive factors and to construct a nomogram.The area under the receiver operating characteristic curve(AUC)was used to evaluate the diagnostic efficacy of the nomogram in differentiating PA and s-AL.Calibration curves were used to analyze the model’s fit,and decision curve analysis(DCA)was used to evaluate the clinical benefits of the model.Results Age,gender,and lesion CT values were identified as independent clinical predictive factors for differentiating PA and s-AL.The nomogram demonstrated good diagnostic efficacy in differentiating PA and s-AL with an AUC of 0.958 in the training set and 0.906 in the test set.Calibration curves and DCA curves indicated that the nomogram model’s predicted results were consistent with actual outcomes and that its clinical benefits were high.Conclusion Thin-layer CT combined with clinical features to construct the nomogram has a better ability to distinguish PA and s-AL,which can provide certain reference value for clinical decision-making.更多还原