摘要
目的探讨非小细胞肺癌CT征象与Ki67表达的关系。方法回归性分析行胸部CT扫描且经手术及病理确诊具有Ki67免疫组化结果的非小细胞肺癌230例。根据Ki67表达百分比分为两组,高表达组59例(Ki67>20%),低表达组171例(Ki67≤20%),应用卡方检验及计Mann-Whitney U检验对CT参数进行统计学分析,采用多因素logistic回归模型,筛选出预测因子及预测概率值,通过ROC曲线比较多参数模型与各单因素参数对于Ki67表达的诊断效能。结果单因素结果发现,边界、密度支气管充气征、结节型/肿块型、阻塞性肺气肿、胸腔积液、肿大淋巴结、多发肿大淋巴结、CT_(mean)、CT_(min)、SD及长径、短径在两组间差异具有统计学意义(P<0.05)。logistic回归结果显示边界、密度、支气管充气征、阻塞性肺气肿、多发肿大淋巴结节、CT_(min)、SD及短径是非小细胞肺癌Ki67表达的有效相关参数ROC曲线结果显示多参数模型曲线下面积为0.913,敏感度为88.1%,特异度为83.0%,结果均优于单因素参数。结论CT相关参数可用于鉴别非小细胞肺癌Ki67表达水平,其中可靠预测因素为边界、密度、支气管充气征、阻塞性肺气肿、多发肿大淋巴结节、CT_(min)、SD及短径。这些CT征象可为评估非小细胞肺癌的癌细胞增殖能力提供参考。
Objective To investigate the relationship between the CT signs of non-small cell lung cancer and the expression of Ki67.Methods Retrospective analysis was performed on 230 cases of non-small cell lung cancer who underwent chest CT scans and were diagnosed with Ki67 immunohistochemical results by surgery and pathology.These cases were divided into two groups according to Ki67 expression percentage,59 cases in the high expression group(Ki67>20%),and 171 cases in the low expression group(Ki67≤20%).Chi-square test and Mann-Whitney U test were used to analyze the CT features statistically.The single factor combined with multivariate logistic regression model was used to screen out the predictive factors and predicted probability values,and the multi-parameter model was compared with each single parameter to predict the efficacy of Ki67 expression through the ROC curve analysis.Results The single factor results found that boundary,composition,bronchial inflation sign,nodular/mass type,obstructive emphysema,pleural effusion,enlarged lymph nodes,multiple enlarged lymph nodes,CT_(mean),CT_(min),SD,long and short diameter were significantly different between the two groups(P<0.05).Logistic regression results showed that boundary,composition,bronchial inflation sign,obstructive emphysema,multiple enlarged lymph nodes,CT_(min),SD,and short diameter were effective predictors of Ki67 expression in non-small cell lung cancer.ROC curve results showed that the area under the curve of the multi-parameter model was 0.913,the sensitivity was 88.1%,and the specificity was 83.0%.The results were better than single factor parameters.Conclusion CT-related parameters can be used to identify the expression level of Ki67 in non-small cell lung cancer.The reliable predictors are boundary,composition,bronchial inflation sign,obstructive emphysema,multiple enlarged lymph nodes,CT_(min),SD,and short diameter.These CT signs can provide reference for evaluating the ability of cancer cell proliferation of non-small cell lung cancer.
作者
李红
闻敏
刘松
陈文萍
周正扬
LI Hong;WEN Min;LIU Song;CHEN Wen-ping;ZHOU Zheng-yang(Department of Radiology,the Affiliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing,Jiangsu 210008,China)
出处
《临床肺科杂志》
2022年第2期251-255,共5页
Journal of Clinical Pulmonary Medicine
关键词
非小细胞肺癌
KI67表达
CT
non-small cell lung cancer
Ki67 expression
computed tomography
