基于术前病理和增强CT影像的口腔癌淋巴结转移诊断

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关键词：口腔癌；淋巴结转移；影像组学；预测

中图分类号：R780.2；TP391 文献标志码：A 文章编号：1001-5779（2025）08-0770-07

DOI：10.3969/j.issn.1001-5779.2025.08.008

Abstract：Objective：To explore theclinical valueofcombining preoperative clinicalpathologicaldataand CTradiomic features for diagnosing lymph node metastasis （LNM）in patients with oralcancer.Methods：Aretrospective analysis was conductedonthe clinical，pathological，and imaging dataof 295 patientsdiagnosed withoral cancer from January 2016 to March 2O23.After excluding patients with incompletedata and unclearimaging，218 cases were included in the study. They were randomlydivided into training group and validation group （training group：152 cases，validation group ： 66 cases）.Two experienced radiologistsused ITK-SNAP software todelineate theregions of interest（ROI）for tumors andlymph nodemetastasis.Subsequently，two independent brancheswere constructed：one branchused a multilayer perceptron（MLP）for featureextractionand dimensionalityreductionof theCTdata，whilethe other branch extracted clinical pathological features.InthethirdlayeroftheMLPneural network，these two typesoffeatureswereintegrated to ultimatelyconstructadiagnosticmodelforlymphnodemetastasis inoralcancer，basedonclinicalpathologicalfeaturesand radiomic features.Results：The model combining clinical pathological features andradiomic featuresperformed wellin diagnosing lymph node metastasis inoral cancer，witharea underthecurve（AUC）of O.997andO.961 forthe training andvalidationsets，respectively.Thecalibration curveanddecision curveof the clinical pathological-radiomic model outperformedthoseof theradiomic modelandtheclinical pathologicalmodelalone.Conclusion：The modelconstructed bycombining preoperative CTand clinical pathological features demonstratedhigh efficiency in predicting lymph node metastasis inoral cancer.It has thepotential for widespread aplication in clinical practice，promoting the precision and personalization of lymph node metastasis diagnosis.

Keywords：Oral cancer；Lymph node metastasis；Radiomics；Prediction

口腔癌是常见的恶性肿瘤之一，约有 10% 的患者在初诊时已存在远处转移现象，病死率高[1-2]。（剩余8168字）