■支气管内超声(EBUS)成像是预测肺癌患者淋巴结(LN)转移的有价值的工具。本研究旨在开发基于EBUS多模态成像的风险评分模型(灰度,多普勒模式,弹性成像)预测肺癌患者的LN转移。
■这项回顾性研究分析了314例肺癌患者的350例转移性LN和96例非特异性炎症患者的124例反应性LN。将超声检查结果与最终病理结果和临床随访进行比较。采用单因素和多因素logistic回归分析评价LNs转移的独立危险因素。根据logistic回归分析中相应指标的β系数,建立了风险评分模型。应用受试者工作特性曲线评价模型的预测能力。
■多变量分析表明,短轴>10毫米,不同的边距,没有中央肺门结构,坏死的存在,非肺门血管,弹性成像评分4~5是LN转移的独立预测因子。短轴和边缘均得1分,其余独立预测因子得2分。3种EBUS模式的组合具有接收器工作特性下的最高区域,精度为0.884(95%置信区间,0.846-0.922)和87.55%,分别。风险分层如下:0到2分,恶性率为11.11%,低怀疑;3到10分,恶性率为86.77%,高度怀疑。
■基于EBUS多模态成像的风险评分模型可以有效评估肺癌患者的转移性LN,以支持临床决策。
UNASSIGNED: Endobronchial ultrasound (EBUS) imaging is a valuable tool for predicting lymph node (LN) metastasis in lung cancer patients. This study aimed to develop a risk-scoring model based on EBUS multimodal imaging (grayscale, Doppler mode, elastography) to predict LN metastasis in lung cancer patients.
UNASSIGNED: This retrospective study analyzed 350 metastatic LNs in 314 patients with lung cancer and 124 reactive LNs in 96 patients with nonspecific inflammation. The sonographic findings were compared with the final pathology results and clinical follow-up. Univariate and multivariate logistic regression analyses were performed to evaluate the independent risk factors of metastatic LNs. According to the β coefficients of corresponding indicators in logistic regression analysis, a risk-scoring model was established. Receiver operating characteristic curve was applied to evaluate the predictive capability of model.
UNASSIGNED: Multivariate analysis showed that short axis >10 mm, distinct margin, absence of central hilar structure, presence of necrosis, nonhilar vascularity, and elastography score 4 to 5 were independent predictors of metastatic LNs. Both short axis and margin were scored 1 point, and the rest of independent predictors were scored 2 points. The combination of 3 EBUS modes had the highest area under the receiver operating characteristic and accuracy of 0.884 (95% confidence interval, 0.846-0.922) and 87.55%, respectively. The risk stratification was as follows: 0 to 2 points, malignancy rate of 11.11%, low suspicion; 3 to 10 points, malignancy rate of 86.77%, high suspicion.
UNASSIGNED: The risk-scoring model based on EBUS multimodal imaging can effectively evaluate metastatic LNs in lung cancer patients to support clinical decision making.