| 摘要: |
| 目的 探讨儿童颅面部朗格汉斯细胞组织细胞增生症(LCH)与淋巴瘤骨受累的超声鉴别价值。方法 连续选取2016年1月至2022年12月北京儿童医院经病理证实的颅面部LCH30例,淋巴瘤46例。对比两组病例的骨破坏超声表现(病灶单发/多发、最大径、内部液化、血供、骨质破坏情况、骨性强回声、邻近淋巴结)是否存在可供鉴别的差异；使用二元Logistic回归分析建立多因素诊断模型；完善自抽样法(Bootstrap)对其区分度进行系统内部验证,并绘制校准曲线完善校准度评价。结果 对比结果提示“单发/多发”、“骨缺损”、“骨性强回声”的差异性具有统计学意义(P=0.019,＜0.001,＜0.001),相应鉴别效能以曲线下面积(AUC)表示为0.637、0.728、0.846；纳入上述因素可有效建立联合诊断用模型,采用该模型AUC可显著提升至 0.940,优于采用单一因素鉴别(P＜0.0001,＜0.0001,0.0041)；内部验证结果提示诊断模型具有稳定区分度(AUC:0.927),同时兼具良好的校准度。结论 超声可有助于LCH与淋巴瘤所致颅面部骨质破坏的鉴别,联合诊断模型可进一步提高超声的诊断价值,具有更好的临床推广前景。 |
| 关键词: 儿童 骨淋巴瘤 LCH 骨质破坏 |
| DOI： |
| 投稿时间：2023-07-10修订日期：2023-08-23 |
| 基金项目: |
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| Ultrasound to identify children craniofacial langerhans cell tissue hyperplasia and lymphoma of bone involvement |
| Chong Jingmin |
| (Beijing childrens hospital,Capital Medical University) |
| Abstract: |
| Objective To investigate the value of ultrasound in the differential diagnosis of craniofacial Langerhans cell histiocytosis (LCH) and bone involvement of lymphoma in children.MethodsTotally 30 patients with craniofacial LCH and 46 patients with lymphoma confirmed by pathology in Beijing Children"s Hospital from January 2016 to December 2022 were consecutively selected.The difference between the two groups of sonographic characteristics (single/multiple lesions, maximum diameter, internalSliquefaction, blood flow and bone damage, osseous hyper echogenicity, adjacent lymph nodes) of bone destruction was compared.Multivariate diagnosis model was established by binary Logistic regression analysis. The self-sampling method (Bootstrap) was used to verify the differentiation within the system, and the calibration curve was drawn to improve the calibration evaluation.Results The difference of “single/multiple lesions” ,“bone damage”, “ osseous hyper echogenicity ”was statistically significant(P=0.019,＜0.001,＜0.001),and the corresponding identification efficiency was expressed by area under the curve (AUC) as 0.637, 0.728, 0.846；The combined diagnosis model could be effectively established by incorporating the above factors, and the AUC of this model could be significantly increased to 0.940, which was better than that of single factor identification (P < 0.0001, < 0.0001, 0.0041).Internal validation results indicated that the diagnostic model has stable differentiation (AUC:0.927) and good calibration.ConclusionsUltrasound can help to distinguish craniofacial bone destruction caused by LCH and lymphoma. The combined diagnostic model can further improve the diagnostic value of ultrasound and has better clinical promotion prospects. |
| Key words: children, bonelymphoma, LCH,bonedamage |
