腔内剪切波成像诊断直肠癌T分期及其与区域淋巴结转移的相关性分析

Intracavitary shear wave imaging in diagnosis of T stage of rectal cancer and its correlation with regional lymph node metastasis

摘要:

目的 研究腔内剪切波弹性成像（SWE）所得杨氏模量值与直肠癌淋巴结转移的相关性；探讨直肠腔内超声（ERUS）联合SWE对直肠癌淋巴结转移的预测价值，并验证其对直肠癌T分期的诊断准确性。方法 回顾性分析2021年11月—2022年11月内蒙古自治区人民医院收治的53例直肠溃疡型中分化腺癌患者的临床资料。所有患者术前接受经ERUS及SWE检查并测量病灶平均杨氏模量值（Emean）。以术后病理为金标准，根据是否发生淋巴结转移，分为淋巴结转移组和无淋巴结转移组，采用Point-biserial相关统计法分析淋巴结转移与Emean值的相关性。以Emean值为依据，采用Logistic回归、随机森林模型、支持向量机模型进一步验证SWE对直肠癌T分期的诊断效果。结果 直肠癌淋巴结转移与病灶的Emean值呈正相关（r_s =0.752，P <0.05），淋巴结转移组与无淋巴结转移组的Emean值比较，差异有统计学意义（P <0.05）；ERUS诊断直肠癌T分期的准确率为71.70%，ERUS联合SWE诊断直肠癌T分期的准确率为86.79%；直肠癌不同T分期的Emean值比较，差异有统计学意义（P <0.05）。结论 ERUS联合SWE对直肠癌淋巴结是否转移有较高的预测价值，同时ERUS联合SWE可提高直肠癌T分期的诊断准确率。

Abstract:

Objective To investigate the correlation between Young's modulus obtained from endorectal shear wave elastography (SWE) and lymph node metastasis in rectal cancer, explore the predictive value of endorectal ultrasound (ERUS) combined with SWE for lymph node metastasis in rectal cancer, and validate its diagnostic accuracy for T staging of rectal cancer.Methods A retrospective analysis was conducted on the clinical data of 53 patients with moderately differentiated adenocarcinoma of rectal ulcer type admitted to Inner Mongolia Autonomous Region People's Hospital from November 2021 to November 2022. All patients underwent preoperative ERUS and SWE examination, and the average Young's modulus value (Emean) of the lesion was measured. According to postoperative pathology as the gold standard and based on whether lymph node metastasis occurred, patients were divided into the lymph node metastasis group and the non-lymph node metastasis group. Point-biserial correlation analysis was used to analyze the correlation between lymph node metastasis and Emean value. Based on Emean value, Logistic regression, random forest model, and support vector machine model were used to further verify the diagnostic effect of SWE on T staging of rectal cancer.Results Lymph node metastasis of rectal cancer was positively correlated with the Emean value of the lesion (r_s = 0.752, P < 0.05), and there was a statistically significant difference in Emean values between the lymph node metastasis group and the non-lymph node metastasis group (P < 0.05). The accuracy of ERUS in diagnosing T staging of rectal cancer was 71.70%, while the accuracy of ERUS combined with SWE in diagnosing T staging of rectal cancer was 86.79%. There were statistically significant differences in Emean values among different T stages of rectal cancer (P < 0.05).Conclusion ERUS combined with SWE has high predictive value for lymph node metastasis in rectal cancer, and it can also improve the diagnostic accuracy of T staging of rectal cancer.