Diagnostic Value of Serum Marker-CT Radiomics Nomogram Model for Mediastinal Lymph Node Metastases in Patients with Non-small Cell Lung Cancer

SUN Yuanyuan; LYU Yongxi; CHENG Zhijie; WAN Zhengguo; ZHANG Hao; LIU Penghua

doi:10.3969/j.issn.1002-3429.2025.04.007

Abstract：Objective To explore the diagnostic value of serum marker-CT radiomics nomogram model for mediastinal lymph node metastases(MLNM)in patients with non-small cell lung cancer(NSCLC).Methods A total of 163 NSCLC pa-tients treated from January 2021 to December 2023 were selected as the training set and divided into MLNM group and non-MLNM group according to postoperative pathology.Another 43 NSCLC patients treated from January to April 2024 were select-ed as the validation set.The general data,serum markers and CT images in the training set were recorded.Double-Z software was used to extract the radiomics features,and Lasso algorithm was used to screen the optimal feature subset.The influencing factors of MLNM in NSCLC patients were analyzed by multivariate logistic regression.The serum marker-CT radiomics nomo-gram model was constructed,and the diagnostic efficiency of this nomogram model in the training set and validation set was an-alyzed by drawing the receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results Carcino-embryonic antigen(CEA),carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),CT ra-diomics score,the proportion of tumor stage III and smoking history in MLNM group were higher than those in non-MLNM group(P＜0.05).CEA,CA125,CYFRA21-1,tumor stage,smoking history and CT radiomics score were independent risk factors for MLNM in NSCLC patients(P＜0.05).In the training set and validation set,the area under the ROC curve of the serum marker-CT radiomics nomogram model for diagnosing MLNM in NSCLC patients was 0.835 and 0.891,respectively.The diagnosis results were highly consistent with the actual results,and the net return rate was the highest in the range of 0.1-0.7 and 0.0-0.8.Conclusion The diagnosis of MLNM in NSCLC patients with serum marker-CT radiomics nomogram model has high efficacy and strong clinical practicability,which is helpful to guide clinical diagnosis and treatment.