术前能谱CT动静脉期碘含量差值联合血清肿瘤标志物、外周血NLR对胃癌患者淋巴结转移的预测价值  

Predictive Value of Preoperative Energy Spectrum CT Arterial and Venous Iodine Content Difference Combined with Serum Tumor Markers and Peripheral Blood NLR for Lymph Node Metastasis in Gastric Cancer Patients

作　　者：彭明[1] 周芳[2] 肖新华[1] 王济国[3] 黄容 石永久[1] PENG Ming;ZHOU Fang;XIAO Xin-hua;WANG Ji-guo;HUANG Rong;SHI Yong-jiu(Department of Imaging,Shenzhen Bao'an District Hospital of Traditional Chinese Medicine,Shenzhen 518100,Guangdong Province,China;Department of Imaging Diagnosis,Southern Hospital of Guangzhou Southern Medical University,Guangzhou 510515,Guangdong Province,China;Department of Oncology,Shenzhen Bao'an District Hospital of Traditional Chinese Medicine,Shenzhen 518100,Guangdong Province,China;Department of Clinical Laboratory,Shenzhen Bao'an District Hospital of Traditional Chinese Medicine,Shenzhen 518100,Guangdong Province,China)

机构地区：[1]深圳市宝安区中医院影像科,广东深圳518100 [2]广州南方医科大学南方医院影像诊断科,广东广州510515 [3]深圳市宝安区中医院肿瘤科,广东深圳518100 [4]深圳市宝安区中医院检验科,广东深圳518100

出　　处：《中国CT和MRI杂志》2023年第9期154-157,共4页Chinese Journal of CT and MRI

基　　金：2019年度广东省医学科研基金立项项目(C2019100)。

摘　　要：目的探讨术前能谱电子计算机断层扫描(CT)动静脉期碘含量差值(nIC)联合血清肿瘤标志物、外周血中性粒细胞与淋巴细胞比值(NLR)对胃癌患者淋巴结转移的预测价值。方法选择深圳市宝安区中医院2019年2月至2021年2月收治的207例行根治手术治疗且经术后病理证实的胃癌患者,所有患者术前均行能谱CT检查,糖链抗原724(CA-724)、糖链抗原242(CA-242)和NLR检测,记录淋巴结转移情况并采用多因素Logistic回归分析其影响因素。ROC分析动静脉期nIC差值、CA-724、CA-242、NLR预测胃癌淋巴结转移的价值。结果126例发生淋巴结转移(转移组),81例未发生淋巴结转移例(未转移组)。转移组动、静脉期碘浓度(IC)值,动、静脉期标准化碘浓度(nIC)值,动静脉期IC差值、动静脉期nIC差值以及血清CA-724、CA-242、NLR均高于未转移组(P<0.05)。T3-4、淋巴管癌栓、动静脉期nIC差值、CA-724、CA-242、NLR水平升高是胃癌淋巴结的危险因素(P<0.05)。动静脉期nIC差值、CA-724、CA-242、NLR预测胃癌患者淋巴结转移的曲线下面积为0.777、0.700、0.711、0.739,联合四项指标预测胃癌患者淋巴结转移的曲线下面积为0.880,高于单独指标。结论胃癌淋巴结转移患者能谱动静脉期nIC差值,血清CA-724、CA-242水平以及NLR显著增高,是胃癌淋巴结转移的危险因素,联合四项指标可更准确地预测胃癌淋巴结转移风险。Objective To investigate the predictive value of preoperative energy spectrum computed tomography(CT)iodine content difference(nIC)in the arteriovenous phase combined with serum tumor markers and peripheral blood neutrophil to lymphocyte ratio(NLR)for lymph node metastasis in patients with gastric cancer.Methods 207 patients with gastric cancer who underwent radical surgery and were confirmed by postoperative pathology in Shenzhen Bao'an District Hospital of Traditional Chinese Medicine from February 2019 to February 2021 were selected.All patients underwent energy spectrum CT examination before operation,glycochain antigen 724(CA-724),glycochain antigen 242(CA-242)and NLR were detected.Lymph node metastasis was recorded and its influencing factors were analyzed using multivariate Logistic regression.ROC was used to analyze the value of nIC difference,CA-724,CA-242 and NLR in predicting lymph node metastasis of gastric cancer.Results There were 126 cases with lymph node metastasis(metastasis group),and 81 cases without lymph node metastasis(non-metastasis group).The iodine concentration(IC)values in the arteriovenous phase,the standardized iodine concentration(nIC)values in the arteriovenous phase,the IC difference in the arteriovenous phase,the nIC difference in the arteriovenous phase,and the serum CA-724,CA-242 and NLR in the metastasis group were higher than those in the non-metastasis group(P<0.05).T3-4,lymphatic vessel tumor thrombus,nIC difference in arteriovenous stage,increased of CA-724,CA-242 and NLR levels were risk factors for lymph node in gastric cancer(P<0.05).The area under curve of nIC difference in arteriovenous stage,CA-724,CA-242 and NLR to predict lymph node metastasis in patients with gastric cancer was 0.777,0.700,0.711 and 0.739,and the area under curve of combined four indicators to predict lymph node metastasis in patients with gastric cancer was 0.880,which was higher than that of single indicators.Conclusion The nIC difference in the arteriovenous phase,serum CA-724,CA-242 and NLR in

关 键 词：胃癌 淋巴结转移 糖链抗原724 糖链抗原242 NLR 能谱CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]