The Diagnostic Value Of Bayes Discriminant Analysis On Metastatic Lymph Nodes Of Esophageal Carcinoma

Part IThe value of spiral CT multiplanar reconstruction technique in the diagnosis of metastatic lymph nodes in esophageal carcinomaObjective:To study the spiral CT multiplanar reconstruction(MPR)after comprehensive transverse,sagittal and coronal of lymph node more surface morphology characteristics compared with traditional CT scans obtained cross-sectional morphology of esophageal cancer lymph node metastasis of lymph node diagnosis efficiency of the difference.Methods:A retrospective analysis of 113 cases of the first diagnosis of esophageal cancer patients with preoperative spiral CT images,measured the lymph nodes were obtained through the cross-sectional CT cross-sectional and long diameter,short diameter by CT multiplanar reconstruction(MPR)after get more lymph node plane short diameter and length to diameter,with short lymph node size,lymph node short-long diameter ratio,joint short diameter and short-long diameter ratio as the criteria for the diagnosis of lymph node,comparative cross-sectional morphology and surface morphology characteristics more lymph node for the differences in the diagnosis of esophageal cancer lymph node metastasis.Results:1.The diagnostic criteria for metastatic lymph nodes of esophageal cancer only with lymph node short diameter.In terms of the diagnosis basis of lymph node short diameter,the area(AUC)was 0.822 and 0.836,respectively,but the difference was not statistically significant.The boundary value,sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 0.67cm and 0.59cm respectively.68.12%,68.04%;84.22%,82.09%;45.04%,43.23%;92.21%,92.76%;80.92%,79.74%.2.The diagnostic criteria for lymph node metastasis of esophageal carcinoma were only with the short length of lymph nodes.Only in lymph node short-long diameter ratio for diagnosis,lymph node cross-sectional short-long diameter ratio and multiple plane short-long diameter ratio as the standard for diagnosis of area under the curve(AUC)were 0.853,0.876,but there was no statistically significant difference.The boundary value,sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 0.70 and 0.57cm respectively.81.65%,78.31%;75.68%,85.05%;40.23%,50.78%;95.36%,94.84%;76.67%,83.70%.3.Combined lymph node short diameter and short length diameter ratio as the diagnostic criteria for lymph node metastasis of esophageal carcinoma.Joint cross-sectional diameter short diameter and short-long lymph node ratio as esophageal cancer lymph node metastasis diagnosis standard,the area under the curve(AUC)of 0.908,than only in lymph nodes short cross sectional diameter,cross-sectional short-long diameter ratio as the standard for diagnosis of the area under the curve(AUC)0.822 and 0.822,the difference had statistical significance(P<0.001,P<0.001);Joint more lymph node plane short diameter and short-long diameter ratio as esophageal cancer lymph node metastasis diagnosis standard,the area under the curve(AUC)was 0.934,more than just to lymph node plane short diameter,multiple planar short-long diameter ratio as the standard for diagnosis of the area under the curve(AUC)0.836,0.876,differences were statistically significant(P<0.001,P<0.001).More lymph nodes and joint plane short diameter and short-long diameter ratio as the standard for the diagnosis of esophageal cancer lymph node metastasis area under curve(AUC)of 0.934 is greater than the combined cross-sectional diameter short diameter and short-long lymph node ratio as the standard for diagnosis of area under curve(AUC)0.908,between the difference was statistically significant(P = 0.005).Conclusions:1.Joint lymph nodes short diameter and short-long diameter ratio as compared with standard for the diagnosis of esophageal cancer lymph node metastasis in lymph nodes short diameter,separate application short-long diameter ratio has the better diagnostic efficiency.2.CT multiplanar reconstruction technique get more plane after the morphological features of esophageal cancer lymph node metastasis lymph nodes diagnosis standard,compared with transverse cross-sectional morphology lymph node,its for diagnosis of esophageal cancer metastasis lymph nodes have better diagnostic efficiency.Part ?To explore the value of Bayes discriminant analysis on the diagnosis of lymph node metastasis of esophageal carcinomaObjective:To establish a comprehensive diagnostic model of CT imaging features of lymph node metastasis of esophageal carcinoma by Bayes discriminant analysis.Methods:the pathological diagnosis of gold standard,a retrospective analysis of 334 cases of esophageal cancer patients with lymph node of preoperative CT images and collect lymph node characteristics including lymph node largest maximum length to diameter,short diameter,lymph node lymph node short-long diameter ratio,clusters,with or without calcification,do you have any central low density,with and without peripheral,maximum cross-sectional area,using stepwise discriminant analysis methods can filter out into the group of variables.Then,334 patients with esophageal cancer were randomly divided into the experimental group(training sample)275 cases(80%),the test group(verified sample)69 cases(20%).The training sample is used to establish the diagnostic equation and the sample is used to verify the equation.Then by standardizing each variable,the standardized contribution of each variable to the judgment of lymph node metastasis was obtained.Results:By stepwise discriminant analysis into the set of variables as follows:the largest maximum length to diameter,short diameter,lymph node lymph node lymph node short-long diameter ratio,with or without calcification,the low density,presence of circular reinforced,maximum cross-sectional area.The variables that were eliminated by stepwise discriminant analysis were:whether they were clusters.The comprehensive diagnostic model of CT imaging features obtained by Bayes discriminant analysis is:Y0=-17.088+2.324X1+1.716X2+18.325X3-3.097X4-3.031X5-3.082X6-0.117X7 Y =-26.636+3.882X1+1.557X2+19.494X3-4.496X4+0.878X5+0.650X6-0.141X7Where Y0 is for transfer group and Y1 as the transfer group;X1 as lymph node largest short diameter,X2 for lymph node length to diameter,the largest X3 for lymph node short-long diameter ratio,X4 for the presence of calcification,X5 for presence of the low density,X6 for presence of circular reinforced,X7 for maximum cross-sectional area.Through the experimental group(training samples)measured by its own inspection method of comprehensive diagnosis model of diagnostic accuracy for 87.2.0%,misjudgment rate was 12.8%,and the results by using the method of cross validation and through its test results are roughly the same.Then,the diagnostic accuracy of the lymph node metastasis of esophageal cancer was 80.9%,and the miscarriage rate was 19.1%,by bringing the data of the test group(verified sample)into the equation of the experimental group(training sample).Finally,after standardization of the variables in the group,the standardized contribution of 7 variables to the diagnosis of lymph node metastasis of esophageal cancer was 1.385,-0.291,0.125,-0.083,0.335,0.235,-0.691.Conclusion:By the Bayes discriminant analysis comprehensive lymph nodes of CT imaging features of multivariate joint diagnosis model has certain clinical value for judgment of lymph node metastasis,and in a variety of CT imaging features of lymph node,lymph nodes short diameter than other imaging characteristics for judgment of lymph node metastasis of contribution is the largest.