Feng Kun, Hu Jing, Huang Qiuyu, Cai Weixin, Zhuang Zehang, Liu Haichao, Hou Jinsong, Liu Xiqiang, Wang Cheng
Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Oral Dis. 2022 Nov;28(8):2131-2138. doi: 10.1111/odi.13859. Epub 2021 Apr 5.
To identify independent factors for head and neck cancer (HNC) patients with carotid blowout syndrome (CBS) and construct a nomogram to predict risk of CBS preoperatively based on computed tomography angiography (CTA) imaging.
From January 2010 to July 2020, 73 HNC patients who had surgery in hospitalization and underwent CTA examination for head and neck region were included in this study. Vascular alterations and the relationship between carotid artery (CA) and tumor were evaluated in CTA. Clinical and CTA imaging features were distinguished by logistic regression analysis and used to perform receiver operating curve analysis. Nomogram was created to predict risk of CBS and assessed by concordance index (C-index) and calibration curve.
Three independent risk factors were identified, including radical neck dissection, CA surrounded by tumor, and CA invaded by tumor without clear boundary. Area under curve of the combination of 3 variables was 0.836 (95% CI, 0.72-0.952, p < 0.001). The C-index of nomogram was 0.84 (95% CI, 0.73-0.94), and the calibration plot showed a good fitting between prediction and observation.
We established a useful nomogram based on CTA imaging, which showed a satisfied efficacy for evaluating risk of CBS in HNC patients preoperatively.
确定头颈部癌（HNC）合并颈动脉破裂综合征（CBS）患者的独立因素，并构建列线图，以基于计算机断层血管造影（CTA）成像术前预测CBS风险。
纳入2010年1月至2020年7月期间住院接受手术并对头颈部区域进行CTA检查的73例HNC患者。在CTA中评估血管改变以及颈动脉（CA）与肿瘤的关系。通过逻辑回归分析区分临床和CTA成像特征，并用于进行受试者工作特征曲线分析。创建列线图以预测CBS风险，并通过一致性指数（C指数）和校准曲线进行评估。
确定了三个独立危险因素，包括根治性颈清扫术、肿瘤包绕CA、肿瘤侵犯CA且边界不清。三个变量组合的曲线下面积为0.836（95%CI，0.72 - 0.952，p < 0.001）。列线图的C指数为0.84（95%CI，0.73 - 0.94），校准图显示预测与观察之间拟合良好。
我们基于CTA成像建立了一个有用的列线图，其在术前评估HNC患者CBS风险方面显示出满意的效果。
