64排光谱CT定量参数对胃癌分化程度的评估价值  

Value of quantitative parameters of 64-slice spectral CT in evaluating the differentiation degree of gastric cancer

作　　者：张首宁 李靖 王雪萍 吴越 曲金荣 ZHANG Shou-ning;LI Jing;WANG Xue-ping;WU Yue;QU Jin-rong(Department of Medical Imaging,the Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital),Zhengzhou 450008,Henan,CHINA)

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)医学影像科,河南郑州450008

出　　处：《海南医学》2024年第3期390-394,共5页Hainan Medical Journal

基　　金：河南省卫生健康科技创新领军人才培养项目(编号:YXKC2020011)。

摘　　要：目的探讨64排光谱CT定量参数对胃癌分化程度的评估价值。方法回顾性分析2021年2月至2023年2月河南省肿瘤医院收治的80例经病理证实的胃癌患者的临床和影像资料,按术后病理分化程度将患者分为中高分化组29例和低分化组51例,比较两组患者病灶动脉期、静脉期及延迟期的有效原子序数(Eff-Z)和碘浓度(IC),并计算三期标准化碘浓度(NIC),绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)以评估64排光谱CT定量参数对胃癌分化程度的诊断效能。结果低分化组患者静脉期的Eff-Z、IC、NIC水平分别为8.34±0.26、(1.62±0.57)mg/mL、0.43±0.08,明显高于中高分化组的8.05±0.15、(0.97±0.39)mg/mL、0.29±0.06,差异均有统计学意义(P<0.05);而两组患者动脉期、延迟期的Eff-Z、IC、NIC比较差异均无统计学意义(P>0.05);经ROC分析结果显示,静脉期Eff-Z、IC、NIC的AUC分别为0.829、0.867、0.765,以8.21为静脉期Eff-Z临界值,敏感度、特异度为68.63%、82.76%;以1.34 mg/mL为静脉期IC临界值,敏感度、特异度为72.55%、93.10%;以0.36为静脉期NIC临界值,敏感度、特异度为58.82%、89.66%。结论64排光谱CT中Eff-Z、IC、NIC定量参数对评估胃癌的分化程度有一定价值,其中静脉期IC具有更高的诊断价值。Objective To investigate the value of quantitative parameters of 64-slice spectral CT in evaluating the differentiation degree of gastric cancer.Methods The clinical and imaging data of 80 patients with pathologically confirmed gastric cancer who were admitted to Henan Cancer Hospital from February 2021 to February 2023 were analyzed retrospectively.The patients were divided into the moderate and high differentiation group(29 cases)and the poor differentiation group(51 cases)according to postoperative pathological differentiation degree.The effective atomic number(Eff-Z)and iodine concentration(IC)in arterial phase,venous phase,and delayed phase were compared between the two groups.The normalized iodine concentration(NIC)in the three phases was calculated.The performance of the quantitative parameters of 64-slice spectral CT in diagnosing the differentiation degree of gastric cancer was evaluated with the area under the receiver operating characteristic(ROC)curve(AUC).Results Eff-Z,IC,and NIC in venous phase of the poor differentiation group were 8.34±0.26,(1.62±0.57)mg/mL,and 0.43±0.08,significantly higher than 8.05±0.15,(0.97±0.39)mg/mL,and 0.29±0.06 in the moderate and high differentiation group(P<0.05).There was no statistically significant difference in Eff-Z,IC,or NIC between the two groups in arterial phase and delayed phase(P>0.05).ROC curve analysis showed that the AUC values of Eff-Z,IC,and NIC in venous phase were 0.829,0.867,and 0.765.With 8.21 as the critical value,the sensitivity and specificity of Eff-Z in venous phase were 68.63%and 82.76%.With 1.34 mg/mL as the critical value,the sensitivity and specificity of IC in venous phase were 72.55%and 93.10%.With 0.36 as the critical value,the sensitivity and specificity of NIC in venous phase were 58.82%and 89.66%.Conclusion The quantitative parameters(Eff-Z,IC,and NIC)of 64-slice spectral CT are helpful for evaluating the differentiation degree of gastric cancer,and IC in venous phase can achieve better diagnostic performance.

关 键 词：胃癌 分化程度 光谱CT 有效原子序数 碘浓度 

分 类 号：R735.2[医药卫生—肿瘤]