摘要
目的探讨双能CT能谱成像增强定量参数预测胃癌增殖抗原Ki-67表达的价值。资料与方法回顾性分析经手术病理证实的47例胃腺癌,均行双能CT三期增强能谱扫描,根据Ki-67表达情况分成高表达组和低表达组。由2名观察者分别测量各期40~70 keV CT值和碘浓度(IC),并计算标准化碘浓度(NIC)值。比较2名观察者各参数的一致性和两组病灶之间的差异;分析两组的鉴别诊断和联合诊断效能;比较各参数的受试者工作特征曲线下面积(AUC);分析与Ki-67表达指数的相关性。结果2名观察者分别测量各参数值的一致性均较好(ICC>0.75)。高表达组动、静脉期40~70 keV CT值、IC值、NIC值,平衡期40、50 keV CT值、IC值、NIC值均低于低表达组(P<0.05),且与Ki-67表达指数均呈负相关(r=-0.762~-0.466,P<0.01)。联合动、静脉期NIC后AUC提高到0.871,联合后的AUC和部分单一参数之间差异有统计学意义(P<0.05)。结论双能CT能谱成像三期各参数值与胃癌Ki-67表达呈负相关,可反映胃癌细胞增殖程度。联合诊断可以提高诊断效能,优于部分单一参数。
Purpose To explore the value of multi-quantitative parameters of spectral CT in predicting the expression of antigen Ki-67 in gastric cancer.Materials and Methods The retrospective analysis was performed on 47 patients with gastric adenocarcinoma,all of whom underwent dual-energy CT phase enhanced spectral scan.According to the expression of Ki-67,all patients were divided into the high and the low expression group.CT and IC of 40-70 keV in each phase were respectively measured by two observers,and NIC was further calculated.The consistency of parameters between the two observers and the difference of lesions between the two groups were compared.The efficacy of differential diagnosis and combined diagnosis of the two groups was analyzed.The area under the curve(AUC)of each parameter was compared,and the correlation with Ki-67 expression index was also analyzed.Results There was good consistency in all parameter values between the two observers(ICC>0.75).All the parameter values of all phase in the high expression group were significantly lower than those of the low expression group(all P<0.05),and all the parameter values of all phase and Ki-67 expression index were negatively correlated with medium and high levels(r=-0.762--0.466,P<0.01).The AUC was up to 0.871 after the combination of the arterial and venous phase,and there were significant differences between the combined AUC and some single parameters(P<0.05).Conclusion In the three phases of dual-energy CT energy spectral imaging,all parameter values were negatively correlated with the expression of Ki-67 in patient with gastric cancer,reflecting the proliferation degree of gastric cancer cells.The application of combined diagnosis can improve the diagnostic efficiency,which is better than single parameter.
作者
王学东
刘爱连
田士峰
孙旭
杨伟萍
牛雅欣
WANG Xuedong;LIU Ailian;TIAN Shifeng;SUN Xu;YANG Weiping;NIU Yaxin(Departent of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第9期885-891,共7页
Chinese Journal of Medical Imaging
基金
首都科技领军人才培养工程(Z181100006318003)。
