基于CT影像和临床特征的列线图模型预测NSCLC的EGFR突变状态

    Prediction of EGFR mutation status in NSCLC using nomogram model based on CT radiological and clinical features

    • 摘要:
      目的探讨基于CT影像和临床特征的预测模型在评估非小细胞肺癌(NSCLC)病人的表皮生长因子受体(EGFR)突变中的价值。
      方法收集经病理确诊的非小细胞肺癌病人258例(其中训练组182例,验证组76例)。采用单因素及多因素logistic回归分析,分析筛选出独立影响EGFR突变因素构建CT影像-临床预测模型。绘制列线图使模型可视化,最后利用受试者工作特性曲线、校准曲线及决策曲线评价模型的实用性。
      结果最终筛选出性别、吸烟状况、毛刺征及胸膜凹陷征为NSCLC EGFR突变的独立预测因素并建立CT影像-临床预测模型。在训练组和验证组中,预测模型曲线下面积分别为0.799和0.797(P < 0.01),预测效能较好。校准曲线显示训练组及验证组预测模型与观察结果具有良好的一致性。DCA显示模型预测EGFR突变取得较好的临床效益。
      结论CT影像-临床特征预测模型对NSCLC病人EGFR突变预测价值良好,可作为临床术前预测的无创性工具。

       

      Abstract:
      ObjectiveTo investigate the value of constructing a combined CT imaging and clinical features prediction model for evaluating epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC).
      MethodsA total of 258 patients with pathologically confirmed NSCLC (182 in the training group and 76 in the validation group) were enrolled. Single factor and multiple factor logistic regression analysis were used to analyze and screen out independent factors affecting EGFR mutation to build CT imaging-clinical prediction model. A nomogram was drawn to visualize the model. Finally, receiver operating characteristic curve, calibration curve and decision curve were used to evaluate the practicability of the model.
      ResultsFinally, gender, smoking status, burr sign, and pleural indentation sign were screened as independent predictive factors for NSCLC EGFR mutations, and a CT imaging-clinical prediction model was established. In the training and validation groups, the predicted area under the curve of the model was 0.799 and 0.797, respectively (P < 0.01), indicating good predictive performance. The calibration curve showed that the prediction models of the training and validation groups had good consistency with the observed results. Decision curve showed that the model had achieved good clinical benefits in predicting EGFR mutations.
      ConclusionsThe CT imaging-clinical feature prediction model has well predictive value for EGFR mutations in NSCLC patients and can be served as noninvasive tool for preoperative clinical prediction.

       

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