摘要
目的探讨能谱CT定量参数在鉴别肺腺癌表皮生长因子受体(EGFR)突变状态中的价值。方法回顾性分析160例经病理证实为肺腺癌并检测EGFR突变状态的患者,包括60例EGFR突变患者和100例EGFR野生型患者。能谱CT定量参数包括CT_(40keV)值、CT_(70keV)值、有效原子序数、碘浓度、水浓度以及通过能谱曲线计算的曲线斜率(λHU)。连续变量和分类变量分别用t检验和χ^(2)检验进行分析。结果女性和非吸烟者在EGFR突变组中更常见,且两组之间差异有统计学意义(P<0.05),而年龄和病理分期在两组之间差异无统计学意义(P>0.05)。动脉期和静脉期,EGFR突变组的定量参数(CT_(40keV)值、CT_(70keV)值、碘浓度、有效原子序数和λHU)均显著高于EGFR野生型组,且两组之间差异有统计学意义(P<0.05),而水浓度在两组之间差异无统计学意义(P>0.05)。动脉期,CT_(40keV)值和CT_(70keV)值鉴别EGFR突变状态的敏感性(81.0%和76.0%)和特异性(70.0%和71.7%)较高,曲线下面积分别为78.8%和80.7%;而在静脉期,敏感性(75.0%和72.0%)和特异性(65.0%和66.7%)略低,曲线下面积分别为76.7%和75.6%。结论能谱CT定量参数(CT_(40keV)值、CT_(70keV)值、碘浓度、有效原子序数和λHU)在鉴别EGFR突变状态中有潜在的价值。
Objective To explore the value of quantitative parameters of spectral CT in the differentiation of EGFR(epidermal growth factor receptor)mutation status in lung adenocarcinoma.Methods A retrospective analysis of 160 patients with pathologically confirmed lung adenocarcinoma with EGFR mutation status was performed,including 60 patients with EGFR mutation and 100 patients with EGFR wild-type.Spectral CT quantitative parameters include CT_(40keV)value,CT_(70keV)value,effective atomic number,iodine concentration,water concentration,and the slope of the curve calculated by spectral curve(λHU).T test andχ^(2)test were used to analyze continuous variables and categorical variables.Results Female and non-smokers were more common in the EGFR mutation group,with statistically significant differences between the two groups(P<0.05),while age and pathological stage were not statistically significant between the two groups(P>0.05).During the arterial and venous phases,the quantitative parameters(CT_(40keV)value,CT_(70keV)value,iodineconcentration,effective atomic number andλHU)of the EGFR mutant group were significantly higher than those of the EGFR wild-typegroup,and there was a statistical difference between the two groups(P<0.05),and the water concentration was not statistically significant between the two groups(P>0.05).In the arterial phase,the CT_(40keV)and CT_(70keV)values have higher sensitivity(81.0%and 76.0%)and specificity(70.0%and 71.7%)to identify EGFR mutation status,and the area under the curve was 78.8%and 80.7%,respectively,while in the venous phase,the sensitivity(75.0%and 72.0%)and specificity(65.0%and 66.7%)is slightly lower,and the area under the curve was 76.7%and 75.6%,respectively.Conclusion The quantitative parameters(CT_(40keV)value,CT_(70keV)value,iodine concentration,effective atomic number,andλHU)of spectral CT have potential value in identifying EGFR mutation status.
作者
张国晋
曹云太
张婧
赵志勇
张文娟
周俊林
ZHANG Guojin;CAO Yuntai;ZHANG Jing(Department of Radiology,Lanzhou University Second Hospital,Lanzhou,Gansu Province 730030,P.R.China)
出处
《临床放射学杂志》
北大核心
2021年第3期448-452,共5页
Journal of Clinical Radiology
关键词
肺腺癌
表皮生长因子受体
能谱CT
Lung adenocarcinoma
Epidermal growth factor receptor
Spectral CT
