宝石能谱CT预测头颈部淋巴瘤Ki-67表达效能的研究  

Study of gemstone spectral CT in predicting Ki-67 expression in head and neck lymphoma

作　　者：赵瑞霞 刘念龙[2] 王玉璜 王梦茹 吴梦婕 吴茜茜 李洁 ZHAO Ruixia;LIU Nianlong;WANG Yuhuang;WANG Mengru;WU Mengjie;WU Qianqian;LI Jie(Department of Medical Imaging,Jiangsu Institute of Cancer Research,the Afiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China;Department of Medical Equipment,Jiangsu Cancer Hospital,Jiangsu Institute of Cancer Research,the Afiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China)

机构地区：[1]江苏省肿瘤医院/江苏省肿瘤防治研究所/南京医科大学附属肿瘤医院医学影像中心,江苏南京210009 [2]江苏省肿瘤医院/江苏省肿瘤防治研究所/南京医科大学附属肿瘤医院医学装备部,江苏南京210009

出　　处：《现代医学》2023年第5期683-687,共5页Modern Medical Journal

基　　金：江苏省卫健委干部保健局课题(BJ18034);江苏省肿瘤医院科研项目(ZL202211)。

摘　　要：目的:探究宝石能谱CT预测头颈部淋巴瘤Ki-67表达的效能。方法:纳入2021年9月至2022年8月期间江苏省肿瘤医院收治的62例头颈部淋巴瘤患者作为研究对象,回顾性分析患者的临床及影像学资料。分析不同CT值、能谱衰减曲线斜率与Ki-67的相关性,构建能谱衰减曲线斜率区分部分病理特征。结果:不同类型的淋巴瘤的CT征象有所不同。在40~140 keV的单能量范围内,动脉期、静脉期的CT值随着单能量的增加呈现出递减的趋势。单能量为60 keV时,Ki-67高表达组的动脉期、静脉期CT值显著高于Ki-67低表达组(P<0.05)。能谱曲线均呈下降趋势,动脉期、静脉期Ki-67高表达组的能谱曲线斜率均显著高于Ki-67低表达组(P<0.05)。动脉期预测Ki-67表达的受试者工作特征曲线下面积(AUC)为0.812 7(95%CI为0.703 2~0.922 2,P<0.000 1),敏感度为78.26%,特异度为79.49%。单能量60 keV(动脉期)预测Ki-67表达的AUC为0.823 9(95%CI为0.706 7~0.941 0,P<0.000 1),敏感度为82.61%,特异度为74.36%。结论:宝石能谱CT的参数中,CT值、能谱曲线与头颈部淋巴瘤患者Ki-67的表达情况存在一定的相关性,其中动脉期能谱曲线斜率、单能60 keV(动脉期)预测Ki-67表达的效能较高。Objective:To investigate the efficacy of gemstone energy spectral CT in predicting Ki-67 expression in head and neck lymphoma.Methods:From September 2021 to August 2022,62 cases of head and neck lymphoma admited to Jiangsu Cancer Hospital were selected as study subjects.The clinical and imaging data of all the patients were analyzed retrospectively.The correlation between different CT values,the slope of energy spectrum attenuation curve and Ki-67 was analyzed,and the slope of energy spectrum attenuation curve was constructed to distinguish the difference of some pathological features.Results:CT signs varied between different types of lymphoma.In the single-energy range of 40-140 keV,the CT values in the arterial and venous phases showed a decreasing trend with the increase of single energy.When the single energy was 60 KeV,the arterial and venous CT values of the Ki-67 high expression group were significantly higher than those in the Ki-67 low expression group(P<0.05).The energy spectrum curves showed a downward trend,and the slope of energy spectrum curves in the arterial and venous Ki-67 high expression groups was significantly higher than that in the Ki-67 low expression group(P<0.05).The AUC expressed by Ki-67 was predicted to be 0.8127(95%CI 0.7032-0.9222,P<0.0001)with the sensitivity of 78.26%and specificity of 79.49%.Single-energy 60 keV(arterial phase)predicted an AUC of 0.8239(95%CI 0.7067-0.9410,P<0.0001)with the sensitivity of 82.61%and specificity of 74.36%for Ki-67 expression.Conclusion:Among the parameters of gemstone energy spectral CT,there is a certain correlation between the CT value and energy spectrum curve and the expression of Ki-67 in patients with head and neck lymphoma,and the slope of the arterial energy spectrum curve and the single energy 60 keV(arterial phase)have higher efficacy in predicting Ki-67 expression.

关 键 词：宝石能谱电子计算机断层扫描 头颈部淋巴瘤 KI-67 

分 类 号：R733.4[医药卫生—肿瘤]