摘要
目的探讨双源双能CT(DSCT)多定量参数与胃癌患者术前分期及肿瘤因子的相关性。方法选取2016年3月至2019年3月于我院收治的120例经病理证实的胃癌患者作为研究对象,对患者临床资料进行回顾性分析。依据病理结果比较Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期患者DSCT双能量图像动脉期和静脉期的标准化碘浓度(NIC)、能谱曲线斜率(K)及双能量指数(DEI),依据术前TNM分期分为Ⅰ~Ⅱ期组和Ⅲ~Ⅳ期组,采用ROC曲线分析NIC、K和DEI对Ⅰ~Ⅱ期和Ⅲ~Ⅳ期的判断效能,并分析不同分期胃癌患者的P53和Her-2阳性率,分析其与NIC、K和DEI的相关性。结果在动脉期,患者不同术前TNM分期的NIC、K和DEI值没有明显差异(P>0.05);在静脉期,患者不同术前TNM分期的NIC、K和DEI值具有明显差异(P<0.05);ROC分析结果显示,NIC、K和DEI值判断胃癌Ⅰ~Ⅱ期和Ⅲ~Ⅳ期的最佳临界值分别为0.482、2.438和0.013,三者联合判断胃癌Ⅰ~Ⅱ期和Ⅲ~Ⅳ期的AUC值高于三项参数分别单独判断的AUC值;胃癌Ⅰ期~Ⅳ期的Her-2和P53阳性率存在明显差异(P<0.05),且分别与胃癌患者静脉期NIC、K和DEI值呈负相关性(P<0.05)。结论DSCT诊断胃癌的静脉期NIC、K和DEI值在不同的术前分期间存在明显差异,胃癌患者的Her-2和P53阳性表达率与DSCT静脉期NIC、K和DEI值呈负相关性,可用于指导胃癌患者术前分期的判断。
Objective To explore correlation between multiple quantitative parameters of dual source computer tomography(DSCT)and preoperative staging,tumor factors of gastric cancer patients.Methods A total of 120 patients pathologically confirmed with gastric cancer who were admitted to the hospital from March 2016 to March 2019 were enrolled as study objects.Their clinical data were retrospectively analyzed.According to pathological results,normalized iodine concentration(NIC),spectrum curve slope(K)and dual energy index(DEI)in arterial and venous phases showed by DSCT dual-energy images were compared among patients at stage Ⅰ,Ⅱ,Ⅲ and Ⅳ.According to preoperative TNM stages they were divided into stage Ⅰ-Ⅱ group and stage Ⅲ-Ⅳ group.ROC curves were applied to analyze judgment efficiency of NIC,K and DEI for stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ The positive rates of P53 and Her-2 in gastric cancer patients of different stages were analyzed.And their correlation with NIC,K and DEI was analyzed.Results In arterial phase,there were no significant differences in NIC,K and DEI among patients with different preoperative TNM staging(P>0.05).In venous phase,there were significant differences in NIC,K and DEI among patients with different preoperative TNM staging(P<0.05).ROC analysis results show that the optimal cutoff values of NIC,K,and DEI for determining gastric cancer at stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ were 0.482,2.438 and 0.013,respectively.AUC of their three combination for determining gastric cancer at stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ was higher than that of them alone.There were significant difference in positive rates of Her-2 and P53 among patients with gastric cancer at stage Ⅰ-Ⅳ(P<0.05),which were negatively correlated with NIC,K and DEI in venous phase(P<0.05).Conclusion There are significant difference in NIC,K and DEI in venous phase diagnosed by DSCT among patients with gastric cancer at different preoperative stages.The positive expression rates of Her-2 and P53 in gastric cancer patients are negatively correlated with NIC,K and DEI in venous phase.They can be applied to guide judgement for preoperative staging of gastric cancer patients.
作者
谢聿娟
张德健
XIE Yu-juan;ZHANG De-jian(Department of Radiology,Ningde Hospital Affiliated to Fujian Medical University,Ningde 352100,Fujian Province,China)
出处
《中国CT和MRI杂志》
2022年第2期130-133,共4页
Chinese Journal of CT and MRI
关键词
双源双能CT
多定量参数
胃癌
术前分期
P53
HER-2
Dual-source CT
Multiple Quantitative Parameter
Gastric Cancer
Preoperative Staging
P53
Her-2
