机构：[1]Department of Medicine Imaging Center, Kunming Medical University, Qujing First People’s Hospital, Yunnan, China[2]Department of Radiology, Sichuan University, West China Hospital, Sichuan, China四川大学华西医院[3]Department of Radiology, Sanya People’s Hospital, Sanya, Hainan, China[4]Department of Joint and Sports Medicine, Kunming Medical University, Qujing First People’s Hospital, Yunnan, China[5]Functional and Molecular Imaging Key Laboratory of Sichuan Province, Sichuan University, West China Hospital, Sichuan, China.四川大学华西医院
The objective is to develop and validate a combined model for noninvasive preoperative differentiating tumor deposits (TDs) from lymph node metastasis (LNM) in patients with rectal cancer (RC). A total of 204 patients were enrolled and randomly divided into 2 sets (training and validation set) at a ratio of 8:2. Radiomics features of tumor and peritumor fat were extracted by using Pyradiomics software from the axial T2-weighted imaging of MRI. Rad-score based on extracted Radiomics features were calculated by combination of feature selection and the machine learning method. Factors (Rad-score, laboratory test factor, clinical factor, traditional characters of tumor on MRI) with statistical significance were integrated to build a combined model. The combined model was visualized by a nomogram, and its distinguish ability, diagnostic accuracy, and clinical utility were evaluated by the receiver operating characteristic curve (ROC) analysis, calibration curve, and clinical decision curve, respectively. Carbohydrate antigen (CA) 19-9, MRI reported node stage (MRI-N stage), tumor volume (cm3), and Rad-score were all included in the combined model (odds ratio = 3.881 for Rad-score, 2.859 for CA19-9, 0.411 for MRI-N stage, and 1.055 for tumor volume). The distinguish ability of the combined model in the training and validation cohorts was area under the summary receiver operating characteristic curve (AUC) = 0.863, 95% confidence interval (CI): 0.8-0.911 and 0.815, 95% CI: 0.663-0.919, respectively. And the combined model outperformed the clinical model in both training and validation cohorts (AUC = 0.863 vs 0.749, 0.815 vs 0.627, P = .0022, .0302), outperformed the Rad-score model only in training cohorts (AUC = 0.863 vs 0.819, P = .0283). The combined model had highest net benefit and showed good diagnostic accuracy. The combined model incorporating Rad-score and clinical factors could provide a preoperative differentiation of TD from LNM and guide clinicians in making individualized treatment strategy for patients with RC.
基金：
Hospital-level Scientific Research Foundation of Qujing First People Hospital [YJKTZ04]; Scientific Research Fund of Education Department of Yunnan province [2023Y0700]; Hainan Province Clinical Medical Center; 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University [ZYGD22004]
第一作者机构：[1]Department of Medicine Imaging Center, Kunming Medical University, Qujing First People’s Hospital, Yunnan, China[2]Department of Radiology, Sichuan University, West China Hospital, Sichuan, China[3]Department of Radiology, Sanya People’s Hospital, Sanya, Hainan, China
通讯作者：
通讯机构：[2]Department of Radiology, Sichuan University, West China Hospital, Sichuan, China[3]Department of Radiology, Sanya People’s Hospital, Sanya, Hainan, China[5]Functional and Molecular Imaging Key Laboratory of Sichuan Province, Sichuan University, West China Hospital, Sichuan, China.[*1]Department of Radiology, Sichuan University, West China Hospital, Sichuan Province 610041, China.Department of Radiology, Sanya People’s Hospital, Sanya, Hainan Province 572000, China.Functional and Molecular Imaging Key Laboratory of Sichuan Province, Sichuan University, West China Hospital, Sichuan 610041, China
推荐引用方式(GB/T 7714)：
Jin Yumei,Wang Yewu,Zhu Yonghua,et al.A nomogram for preoperative differentiation of tumor deposits from lymph node metastasis in rectal cancer: A retrospective study[J].MEDICINE.2023,102(41):doi:10.1097/MD.0000000000034865.
APA：
Jin, Yumei,Wang, Yewu,Zhu, Yonghua,Li, Wenzhi,Tang, Fengqiong...&Song, Bin.(2023).A nomogram for preoperative differentiation of tumor deposits from lymph node metastasis in rectal cancer: A retrospective study.MEDICINE,102,(41)
MLA：
Jin, Yumei,et al."A nomogram for preoperative differentiation of tumor deposits from lymph node metastasis in rectal cancer: A retrospective study".MEDICINE 102..41(2023)
