logistic回归模型评价常规超声及超声造影对胆管细胞癌与肝细胞癌的鉴别诊断价值

叶显俊; 胡蕾; 何年安; 卫梅; 刘潇; 刘文斌

doi:10.3969/j.issn.1001-5256.2019.11.022

logistic回归模型评价常规超声及超声造影对胆管细胞癌与肝细胞癌的鉴别诊断价值

DOI: 10.3969/j.issn.1001-5256.2019.11.022

1. 中国科学技术大学附属第一医院(安徽省立医院)超声科
2. 中国科学技术大学附属第一医院(安徽省立医院)普外科

基金项目:

国家自然科学基金面上项目(81272398)；

详细信息

中图分类号: R445.1;R735
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出版历程
- 收稿日期: 2019-06-25
- 出版日期: 2019-11-20

Value of conventional ultrasonography and contrast-enhanced ultrasound in the differential diagnosis of intrahepatic cholangiocellular carcinoma and hepatocellular carcinoma: An analysis based on the logistic regression model

Department of Ultrasound,The First Affiliated Hospital of University of Science and Technology of China & Anhui Provincial Hospital

Research funding:

摘要

摘要: 目的建立胆管细胞癌（ICC）常规超声特征及"周边环状强化"超声造影增强模式为变量的logistic回归模型,评价常规超声以及超声造影在ICC与肝细胞癌（HCC）鉴别诊断中的价值。方法回顾性分析55例ICC患者以及42例HCC患者的常规超声及超声造影图像特点,以手术病理或活组织检查病理为诊断金标准。评价利用logistic回归模式分析筛选出的病灶回声、血供类型、胆管扩张以及"周边环状强化"超声造影模式4个超声特征在ICC与HCC鉴别诊断中的价值。计量资料组间比较采用t检验;计数资料组间比较采用χ2检验。对单因素分析结果中有统计学意义的因素作为自变量再进行二分类logistic回归分析。对整个模型的拟合情况采用似然比检验,筛选出各个特征中与ICC定性诊断似然比最高者。绘制logistic回归分析模型定性诊断ICC的受试者工作特征曲线（ROC曲线）,计算其曲线下面积（AUC）。结果 2组患者在病灶回声（χ2=4. 813,P <0. 05）、血供类型（χ2=10. 222,P <0. 01）、胆管扩张（χ...
- 超声检查 /
- 胆管上皮癌 /
- 癌,肝细胞
Abstract: Objective To investigate the value of conventional ultrasonography( US) and contrast-enhanced ultrasound( CEUS) in the differential diagnosis of intrahepatic cholangiocellular carcinoma( ICC) and hepatocellular carcinoma( HCC) by establishing a logistic regression model with the variables of US features and CEUS enhancement pattern( circumferential ring enhancement). Methods A retrospective analysis was performed for the US and CEUS features of 55 ICC patients and 42 HCC patients,and the results of surgical pathology or biopsy were used as the golden standard for diagnosis. A logistic regression analysis was used to evaluate the value of four US features,lesion echo,blood supply type,bile duct dilatation,and circumferential ring enhancement of CEUS,in the differential diagnosis of ICC and HCC. The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups. A binary logistic regression analysis was performed for the factors with statistical significance in univariate analysis. Likelihood ratio was used to evaluate the fitting of the whole model,and the feature with the highest likelihood ratio in the qualitative diagnosis of ICC was screened out. The receiver operating characteristic( ROC) curve was plotted for the logistic regression model in the qualitative diagnosis of ICC,and the area under the ROC curve( AUC) was calculated. Results There were significant differences between the two groups in lesion echo( χ2= 4. 813,P < 0. 05),blood supply type( χ2= 10. 222,P < 0. 01),bile duct dilatation( χ2= 40. 669,P < 0. 01),and circumferential ring enhancement of CEUS( χ2= 8. 180,P < 0. 01),and these four features had a sensitivity of 58. 15%,72. 73%,67. 27%,and 69. 09%,respectively,and a specificity of 64. 29%,59. 52%,66. 4%,and 95. 24%,respectively,all P < 0. 05,in the differential diagnosis of ICC and HCC. Type of lesion echo,blood supply,circumferential ring enhancement of CEUS,and presence or absence of bile duct dilatation had an odds ratio of 3. 556,4. 107,4. 223,and 5. 776,respectively. The binary logistic regression equation was Logistic( P) =-2. 761 + 1.272 X1 + 1. 430 X2 + 1. 538 X3 + 1. 743 X4. The likelihood-ratio test of this model showed a significant difference in this regression equation( χ2= 94. 691,P < 0. 001). In the qualitative diagnosis of ICC,this regression equation had a sensitivity of 74. 3%,a specificity of 82. 2%,and an AUC of 0. 856. There was a significant difference in time to peak between the two groups( t = 8. 497,P < 0. 01). Conclusion The logistic regression model and CEUS qualitative analysis can improve the qualitative diagnosis of ICC.
- ultrasonography /
- cholangiocarcinoma /
- carcinoma,hepatocellular

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参考文献(19)

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