分类决策树辅助盆腔MRI术前诊断子宫内膜癌伴卵巢恶性肿瘤

发布时间：2018-01-11 13:35

本文关键词：分类决策树辅助盆腔MRI术前诊断子宫内膜癌伴卵巢恶性肿瘤　出处：《中国介入影像与治疗学》2017年11期 　论文类型：期刊论文

【摘要】：目的采用分类决策树方法,探索盆腔MRI结合患者临床信息在术前诊断子宫内膜癌合并卵巢恶性肿瘤中的价值。方法回顾性分析801例子宫内膜癌患者资料,其中伴卵巢恶性肿瘤者(EC-OMT组)58例,不伴者(EC组)743例,比较两组患者术前临床资料及盆腔MRI征象,计算盆腔MRI对子宫内膜癌合并卵巢恶性肿瘤的诊断效能,采用决策树模型筛选有效的术前诊断指标。结果 EC-OMT组子宫内膜病变浸润肌层深度超过EC组,其侵犯宫颈和宫角、发生腹盆腔淋巴结转移、腹膜转移的比例以及附件区发现肿物的比例均大于EC组,差异均有统计学意义(P均0.01)。两组间宫旁受累差异无统计学意义(1.72%vs 0.40%,P=0.26)。盆腔MRI术前诊断子宫内膜癌合并卵巢恶性肿瘤的敏感度为51.72%(30/58),特异度为99.87%(742/743)。经决策树模型筛选出3项有诊断意义的指标:宫角受累、附件区肿物及血清CA125,诊断子宫内膜癌合并卵巢恶性肿瘤的敏感度为89.66%(52/58)。结论采用分类决策树方法对盆腔MRI和相关临床信息建立决策树模型,可提高对子宫内膜癌合并卵巢恶性肿瘤的术前诊断敏感度。
[Abstract]:Objective to adopt the classification decision tree method. To explore the value of pelvic MRI combined with clinical information in preoperative diagnosis of endometrial carcinoma with ovarian malignant tumor. Methods 801 patients with endometrial carcinoma were retrospectively analyzed. There were 58 cases with malignant ovarian tumor in EC-OMT group and 743 cases without EC group. The preoperative clinical data and pelvic MRI findings were compared between the two groups. To evaluate the diagnostic efficacy of pelvic MRI in endometrial carcinoma complicated with ovarian malignant tumor. Results the depth of myometrium invasion in EC-OMT group was higher than that in EC group, which invaded cervix and uterus angle and metastasis of abdominal and pelvic lymph nodes. The proportion of peritoneal metastasis and the proportion of tumors found in adnexal area were higher than those in EC group. The difference was statistically significant (P < 0.01). There was no significant difference in paracentricular involvement between the two groups (1.72 vs 0.40%). The sensitivity of pelvic MRI in diagnosis of endometrial carcinoma associated with ovarian malignant tumor was 51.72% and 30 / 58). The specificity was 99.877.72 / 7430.Three diagnostic indexes were selected by the decision tree model: involvement of uterine horn, tumor in adnexal area and serum CA125. The sensitivity of diagnosis of endometrial carcinoma with ovarian malignant tumor was 89.66 / 58.Conclusion the decision tree model of pelvic MRI and related clinical information was established by using classification decision tree method. It can improve the sensitivity of preoperative diagnosis of endometrial carcinoma complicated with ovarian malignant tumor.
【作者单位】：国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科;北京大学第三医院临床流行病学研究中心;
【分类号】：R445.2;R737.3
【正文快照】： 子宫内膜癌是女性生殖系统常见的三大恶性肿瘤之一,多发生于绝经后妇女,绝经前患者约占20%[1]。近年来子宫内膜癌发病率呈逐年上升及年轻化趋势[2]。根据国际妇产科联盟(International　Federationof　Gynecology　and　Obstetrics,FIGO)制定的全面分期手术标准,其标准术式为

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