李春鸣　余更生　崔恩铭　饶建　雷芳勇　周树权

【摘要】 目的：分析影像組学特征在肝癌放疗敏感性评价中的应用价值。方法：选择2014年1月-2019年12月本院收治的以放射治疗作为首要治疗方式的60例肝癌患者为观察对象。根据放疗效果，将患者分为敏感组26例和不敏感组34例。收集患者肝脏CT资料，以放疗病灶为观察区域，应用影像组学分析软件，提取放疗病灶的影像组学特征。分析影像组学特征对肝癌放疗敏感性的影响。结果：将两组影像组学数据导入SPSS 20.0软件，单因素logistic回归分析结果显示，灰度共生矩阵数据中同质性、能量性及对比性，灰色水平运行长度矩阵数据中短期强调、长期强调及长度不均匀，灰度区域长度矩阵数据中长带强调、长带低灰度强调及长带高灰度强调均为影响放疗敏感性的单因素指标（P<0.05）。多因素logistic回归分析结果显示，灰度共生矩阵数据中同质性、能量性及对比性，灰色水平运行长度矩阵数据中短期强调及长期强调，灰度区域长度矩阵数据中长带低灰度强调及长带高灰度强调均为影响放疗敏感性的多因素指标（P<0.05）。结论：肝癌放疗治疗前影像组学特征与放疗敏感性有关，可作为评价放疗敏感性的重要指标。

【关键词】 影像组学特征 肝癌 放疗敏感性

Analysis of the Influence of Imaging Characteristics on Radiotherapy Sensitivity of Hepatocellular Carcinoma/LI Chunming， YU Gengsheng， CUI Enming， RAO Jian， LEI Fangyong， ZHOU Shuquan. //Medical Innovation of China， 2021， 18（23）： -159

[Abstract] Objective： To analyze the application value of imaging characteristics in the evaluation of radiotherapy sensitivity of liver cancer. Method： A total of 60 patients with hepatocellular carcinoma treated in our hospital from January 2014 to December 2019 with radiotherapy as the primary treatment were selected as the observation objects. According to the effect of radiotherapy， the patients were divided into sensitive group （n=26） and insensitive group （n=34）. The liver CT data of the patients were collected， and the radiomeric features of the radiotherapy lesions were extracted using radiomic analysis software， taking the radiotherapy lesions as the observation area. The influence of radiomeric features on radiotherapy sensitivity of liver cancer was analyzed. Result： The two groups of imaging omics data were imported into SPSS 20.0 software. The results of single-factor logistic regression analysis show that the homogeneity， energy and comparability of gray co-occurrence matrix data， short-term emphasis， long-term emphasis and uneven length of gray horizontal running length matrix data， in gray area length matrix data， long band emphasis， long band low gray emphasis and long band high gray emphasis were single factor indexes affecting radiotherapy sensitivity （P<0.05）. The results of multivariate logistic regression analysis showed that homogeneity， energy and contrast in gray level co-occurrence matrix data， medium and short-term emphasis and long-term emphasis in gray level operation length matrix data， long band low gray emphasis and long band high gray emphasis in gray area length matrix data were multi factor indexes affecting radiotherapy sensitivity （P<0.05）. Conclusion： The imaging characteristics of liver cancer before radiotherapy are related to radiotherapy sensitivity， which can be used as an important index to evaluate radiotherapy sensitivity.

[Key words] Imaging characteristics Hepatocellular carcinoma Radiotherapy sensitivity

First-author’s address： Jiangmen Central Hospital， Jiangmen 529000， China

doi：10.3969/j.issn.1674-4985.2021.23.038

肝癌为临床最为常见的消化系统恶性肿瘤之一，因肝癌的隐匿性较高，故多数患者确诊时已经处于肿瘤晚期，预后往往并不理想[1-2]。近年来，随着放疗技术的发展，其在局部晚期肝癌治疗中的地位逐渐提高，且已被多个临床指南所推荐，但因放疗存在放射性肝损伤的不良反应，在一定程度上也降低了患者治疗的依从性[3-5]。……