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论文摘要

增强CT下的生境分析模型对口腔鳞状细胞癌的预测能力分析

Contrast-enhanced CT-based habitat radiomics for analyzing the predictive capability for oral squamous cell carcinoma

作者:刘其林, 梁壮, 杨舒雯, 董会

Author:Liu Qilin, Liang Zhuang, Yang Shuwen, Dong Hui

收稿日期:2025-05-19          年卷(期)页码:2026,44(2):277-277-285

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:口腔鳞状细胞癌,影像组学,精准医学,生境分析,深度学习,

Key words:oral squamous cell carcinoma,radiomics,precision medicine,habitat analysis,deep learning,

基金项目:

中文摘要

目的 通过比较基于增强CT(CECT)的生境分析模型,探索一种预测口腔鳞状细胞癌颈部淋巴结转移及病理分型的新方法,为癌症的早期干预和综合诊疗提供参考。 方法 回顾性收集107例经病理诊断为口腔鳞状细胞癌患者的CECT,所有患者均行原发灶切除及颈淋巴结清扫术。利用K-means聚类将CECT下的感兴趣区域图像分为3个区域,通过全连接神经网络筛选出18个特征向量,构建口腔癌生境分析预测模型。通过患者年龄、性别、不良习惯、肿瘤部位、临床TNM分期等相关临床特征,构建临床模型。以病理分型和淋巴结转移为研究结局,通过混淆矩阵、受试者工作(ROC)曲线分析分别比较临床模型、生境分析模型、临床+生境组合模型的预测能力。 结果 生境+临床组合模型展现出更强的预测性能:对淋巴结转移的预测中,ROC曲线下面积(AUC)为0.97;对病理分型的预测中,其AUC值分别为高分化1.00、中分化0.94、低分化1.00,该模型对病理分型及淋巴结转移的预测能力均高于单一的临床模型和生境模型。 结论 在本研究条件下,临床+生境组合模型对口腔癌的淋巴结转移和病理分型的预测能力更加精准。

英文摘要

ObjectiveBy comparing deep learning and habitat analysis models based on contrast-enhanced CT (CECT), this study explores a novel approach to predict cervical lymph node metastasis and pathological subtypes in oral squamous cell cancer (OSCC).MethodsCECT images from patients diagnosed with OSCC by paraffin pathology were retrospectively collected. A total of 107 patients underwent primary lesion resection and cervical lymph node dissection. Region-of-interest images under CECT were divided into three regions using K-means clustering, and feature selection was performed through a fully connected neural network to construct a habitat analysis model. A clinical model was constructed using nine clinical features, including age, gender, and tumor location. With pathological subtypes and lymph node metastasis (LNM) as study endpoints, the predictive capabilities of the clinical model, deep learning model, habitat analysis model, and combined clinical + habitat model were compared using confusion matrices and receiver operating characteristic (ROC) curve.ResultsThe habitat-clinical combined model exhibits superior predictive performance: in the prediction of lymph node metastasis, the area under the receiver operating characteristic curve (AUC) reaches 0.97. In the prediction of pathological typing, the AUC values are 1.00 for well-differentiated type, 0.94 for moderately differentiated type, and 1.00 for poorly differentiated type. This combined model outperforms the standalone clinical and habitat models in predicting pathological typing and lymph node metastasis.ConclusionThe habitat-clinical integrated model exhibits superior predictive efficacy in evaluating LNM and pathological classification in oral carcinoma.

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