能谱CT联合血清G-17、CEA在术前预测胃癌病理分级中的价值研究  

Study on value of spectral CT combined with serum G-17 and CEA in predicting pathological grading of gastric cancer before surgery

作　　者：李琰 郭洋洋 赵森[1] 杜森 周青[1] Li Yan;Guo Yangyang;Zhao Sen;Du Sen;Zhou Qing(Department of Medical Imaging,the First Affiliated Hospital of Henan University,Kaifeng,Henan 450052,China;Department of Medical Imaging,No.988 Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army,Kaifeng,Henan 4540003,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封450052 [2]中国人民解放军联勤保障部队第九八八医院开封医疗区医学影像科,454003

出　　处：《齐齐哈尔医学院学报》2024年第16期1564-1567,共4页Journal of Qiqihar Medical University

基　　金：2022年开封市科技发展计划(2207008)。

摘　　要：目的探究能谱CT联合血清G-17、CEA在术前预测胃癌病理分级中的应用价值。方法选择2021年7月—2023年3月本院收治的75例胃癌患者的临床资料进行回顾性分析。根据肿瘤细胞分化程度将患者分为低分化组(38例)和中高分化组(37例)两组。分析所有患者术前能谱CT检查结果和血清G-17、CEA表达水平。结果低分化组胃癌患者静脉期的碘基值、能谱曲线斜率、有效原子序列明显高于中高分化组(P<0.05)。低分化组胃癌患者血清G-17、CEA水平明显高于中高分化组胃癌患者(P<0.05)。胃癌患者静脉期的碘基值、能谱曲线斜率、有效原子序列及血清G-17、CEA各项指标指标间均具有相关性,(P<0.05)。胃癌患者静脉期的碘基值、能谱曲线斜率、有效原子序列及血清G-17、CEA在预测胃癌患者病理分级的ROC曲线下面积分别为0.815、0.778、0.702、0.749、0.747,差异均有统计学意义(P<0.05)。联合检测ROC曲线下面积为0.962(P<0.05)。联合检测的AUC明显高于静脉期的碘基值、能谱曲线斜率、有效原子序列及血清G-17、CEA各指标单独检测(P<0.05)。结论术前通过评估胃癌患者能谱CT碘浓度变化,并结合血清G-17、CEA表达,对预测胃癌病理分级有参考价值。Objective To explore the application value of energy spectral CT combined with serum G-17 and CEA in preoperative prediction of pathological grading of gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 75 gastric cancer patients who were admitted to our hospital from July,2021 to March,2023.Patients were divided into two groups based on the degree of tumor cell differentiation:a poorly differentiated group of 38 cases;37 cases in the medium to high differentiation group.The preoperative energy spectrum CT examination results and serum G-17 and CEA expression levels of all patients were analyzed.Results The iodine base value,energy spectrum curve slope,and effective atomic sequence of gastric cancer patients in the venous phase in the low differentiation group were significantly higher than those in the medium to high differentiation group(P<0.05).The serum levels of G-17 and CEA in patients with gastric cancer in the low differentiation group were significantly higher than those in patients with gastric cancer in the medium to high differentiation group(P<0.05).There was a correlation between the iodine base value,energy spectrum curve slope,effective atomic sequence,and various indicators of serum G-17 and CEA in gastric cancer patients during the venous phase(P<0.05).The area under the ROC curve of iodine base value,energy spectrum curve slope,effective atomic sequence,serum G-17 and CEA in predicting the pathological grading of gastric cancer patients during the venous phase were 0.815,0.778,0.702,0.749,and 0.747,respectively(P<0.05).The area under curve of the joint detection of the iodine base value,energy spectrum curve slope,effective atomic sequence,serum G-17 and CEA was 0.962(P<0.05).Conclusions Preoperative evaluation of energy spectrum CT iodine concentration changes in gastric cancer patients,combined with serum G-17 and CEA expression,has reference value for predicting pathological grading of gastric cancer.

关 键 词：能谱CT 血清G-17 血清CEA 术前预测 胃癌病理分级 

分 类 号：R445.3[医药卫生—影像医学与核医学]