摘要
目的观察CT直方图参数与食管鳞状细胞癌(ESCC)表皮生长因子受体(EGFR)表达状态的相关性,评价其预测ESCC的EGFR表达状态的效能。方法回顾性分析109例经术后病理证实ESCC患者术前胸部CT,获取其直方图参数。记录EGFR检测结果,将EGFR表达(-/+)归为低表达,EGFR表达(++/+++)归为高表达。比较EGFR高、低表达ESCC间直方图参数的差异。针对差异有统计学意义的参数行受试者工作特征(ROC)曲线分析,评价其预测EGFR表达状态的效能,分析CT直方图参数与EGFR表达的相关性。结果109例ESCC中,40例EGFR低表达,69例高表达;其中22例EGFR表达(-),18例(+),27例(++),42例(+++)。EGFR高、低表达肿瘤的平扫CT灰度平均值(Mean)、最大值(Max)、第10、25、50、75、90百分位数(10 ^( th)、25 ^( th)、50 ^( th)、75 ^( th)、90 ^( th) percentile)、峰度(kurtosis)及增强前后参数差值ΔMean、Δ50 ^( th)、Δ75 ^( th)、Δ90 ^( th) percentile差异均有统计学意义(P均<0.05)。平扫CT肿瘤灰度75 ^( th)和90 ^( th) percentile预测ESCC的EGFR表达状态的诊断效能最优,曲线下面积(AUC)均为0.69。平扫CT Mean、Max、Min、5^( ^( th))、10 ^( th)、25 ^( th)、50 ^( th)、75 ^( th)、90 ^( th) percentile、kurtosis、ΔMean及Δ5 ^( th)、Δ10 ^( th)、Δ25 ^( th)、Δ50 ^( th)、Δ75 ^( th) percentile与EGFR表达呈弱至低度相关(|r|=0.20~0.37,P均<0.05),增强CT直方图参数与EGFR表达无明显相关。结论平扫CT直方图参数可用于术前预测ESCC的EGFR表达状态,尤以75 ^( th)和90 ^( th) percentile效能较佳。
Objective To explore ^( th)e correlations of CT histogram parameters and epidermal grow^( th) factor receptor(EGFR)expression status of esophageal squamous cell carcinoma(ESCC),and to analyze ^( th)e efficacy of CT histogram parameters for predicting EGFR expression status of ESCC.Me^( th)ods Preoperative chest CT of 109 patients wi^( th) ESCC confirmed by postoperative pa^( th)ology were retrospectively analyzed,and histogram parameters were obtained wi^( th) histogram analysis.EGFR test results were recorded,and EGFR expression(-/+)were classified as low expression,while EGFR expression(++/+++)were identified as high expression.The histogram parameters of ESCC were compared between low and high EGFR expression.receiver operating characteristic(ROC)curve was used to analyze ^( th)e efficacy of parameters wi^( th) being statistically different between low and high EGFR expression for predicting EGFR expression status of ESCC.Then ^( th)e correlations of CT histogram parameters and EGFR expressions were analyzed.Results Among 109 ESCC,40 cases were wi^( th) EGFR low expression and 69 were wi^( th) high expression,including 22 cases expressed EGFR(-),18 cases(+),27 cases(++)and 42 cases(+++).Significant differences of ^( th)e mean value(Mean),^( th)e maximum value(Max),^( th)e 10^( th),25^( th),50^( th),75^( th),90^( th) percentile(10 ^( th),25 ^( th),50 ^( th),75 ^( th),90 ^( th) percentile),kurtosis of plain CT and parameter differences before and after enhancementΔMean,Δ50 ^( th),Δ75 ^( th),Δ90 ^( th) percentile were found between ESCC wi^( th) high and low expression of EGFR(all P<0.05).ROC curve results showed ^( th)at ^( th)e 75 ^( th) and 90 ^( th) percentile of plain CT had ^( th)e best diagnostic efficiency in predicting high and low EGFR expression,bo^( th) wi^( th) ^( th)e area under ^( th)e curve(AUC)of 0.69.The Mean,Max,minimum value(Min),^( th)e 5 ^( th),10 ^( th),25 ^( th),50 ^( th),75 ^( th),90 ^( th) percentile,kurtosis of plain CT andΔMean,Δ5 ^( th),Δ10 ^( th),Δ25 ^( th),Δ50 ^( th),Δ75 ^
作者
郑欢欢
季长风
李琳
刘松
周科峰
ZHENG Huanhuan;JI Changfeng;LI Lin;LIU Song;ZHOU Kefeng(Department of Medical Imaging,,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Pathology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《中国医学影像技术》
CSCD
北大核心
2021年第4期537-541,共5页
Chinese Journal of Medical Imaging Technology
基金
十三五南京市卫生青年人才培养工程(QRX17056)。
