Myrian影像后处理系统在老年早期肺癌诊断中的应用

Application of Myrian post-processing system in the diagnosis of early-stage lung cancer in the elderly

摘要:

目的 分析Myrian影像后处理系统在老年早期肺癌诊断中的临床意义。方法 回顾性收集2016年11月至2017年11月河北省沧州市人民医院胸外科病例资料完整行肺部结节手术的患者57例。术前患者先经64排螺旋CT扫描并由医师评估结节恶性或良性；将影像学参数输入Myrian影像后处理系统,进行3D图像重建,再由医师重新进行评估。同时根据Myrian系统自带公式计算早期肺癌危险度。比较64排螺旋CT扫描与Myrian影像后处理系统对术前老年早期肺癌的检出率。术后以病理结果为金标准,评价Myrian系统评估老年早期肺癌的灵敏度、特异度、阳性预测值、阴性预测值。采用SPSS 20.0 统计软件进行数据分析。组间比较采用χ² 或Fisher精确概率检验。采用受试者工作特征(ROC)曲线分析,判断Myrian系统评估老年早期肺癌危险度的截断点。结果 与64排螺旋CT扫描比较,Myrian系统处理对肺癌的检出率明显增加[71.93%(41/57) vs 52.63%(30/57),P=0.03]。Myrian后处理系统评估老年早期肺癌的灵敏度、特异度、阳性预测值、阴性预测值分别为85.42%(41/48)、66.67%(6/9)、93.18%(41/44)、46.15%(6/13)。ROC曲线表明,Myrian危险度截断点为26%,曲线下面积0.750(95%CI 0.612~0.888,P＜0.05)。结论 Myrian影像后处理系统检测对我国老年人早期肺癌具有诊断价值,可为肺结节临床决策提供依据。

Abstract:

Objective To investigate the clinical significance of Myrian post-processing system in the diagnosis of early-stage lung cancer in the elderly. Methods A total of 57 patients with complete data were retrospectively analyzed, who underwent surgery for pulmonary nodules in the Department of Thoracic Surgery of Cangzhou People′s Hospital of Hebei Province from November 2016 to November 2017. Preoperatively, all the patients underwent 64-slice spiral CT, and the nodules were evaluated and determined as malignant or benign by the physician. The imaging parameters were entered into Myrian system for 3D reconstruction, and the nodules were reevaluated accordingly by the physician. At the same time, the risk of early-stage lung cancer was obtained using built-in formula of Myrian system. Postoperatively, using pathological results as gold standard, Myrian system was evaluated in terms of sensitivity, specificity, positive predictive value, and negative predictive value. SPSS statistics 20.0 was used for data analysis. Chi-square test or Fisher exact probability test was performed for comparison between groups. Based on the receiver operating characteristic (ROC) curve analysis, cut-off value of Myrian system was determined for the risk assessment of early-stage lung cancer. Results Myrian system had a significantly higher detection rate than 64-slice spiral CT [71.93%(41/57) vs 52.63%(30/57),P=0.03]. The Myrian system showed a sensitivity of 85.42%(41/48), a specificity of 66.67%(6/9), a positive predictive value of 93.18%(41/44), and a negative predictive value of 46.15%(6/13) in the diagnosis of early-stage lung cancer in the elderly. The ROC curve indicated that cut-off value of risk in Myrian system was 26%, and that the area under the curve was 0.750 (95%CI 0.612-0.888, P<0.05). Conclusion Myrian post-processing system has diagnostic value for early-stage lung cancer in the elderly Chinese population, providing basis for clinical decisions in pulmonary nodules.