光谱CT定量参数预测结直肠癌增殖抗原Ki-67表达水平的价值  

The Value of Quantitative Parameters of Dual Layer Spectral Detector CT in Evaluating the Expression Level of Ki-67antigen in Colorectal Cancer

作　　者：魏博 李青青[1] 杨亚英[1] 李亚敏[1] WEI Bo;LI Qingqing;YANG Yaying(Department of Radiology,The First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,P.R.China)

机构地区：[1]昆明医科大学第一附属医院影像科,650032

出　　处：《临床放射学杂志》2024年第9期1529-1533,共5页Journal of Clinical Radiology

基　　金：云南省放射与治疗临床医学研究中心专项基金子课题项目(编号:202102AA100067)。

摘　　要：目的探讨双层探测器光谱CT定量参数评估结直肠癌(CRC)增殖抗原Ki-67表达水平的价值。方法回顾性搜集2021年10月至2023年9月于昆明医科大学第一附属医院经病理证实的CRC患者92例,所有患者均行光谱CT腹部三期增强扫描,根据Ki-67表达指数将其分为高表达组(n=56,Ki-67>50%)和低表达组(n=36,Ki-67≤50%)。测量病灶增强三期碘浓度(IC)、有效原子序数(Eff-Z)、CT_(40 keV)、CT_(70 keV)、CT_(100 keV),并计算标准化碘浓度(NIC),能谱曲线斜率(λ_(HU)),比较各期增强组间各参数的差异。采用Spearman相关系数评价有统计学意义的参数与Ki-67表达水平的相关性,绘制受试者工作特征(ROC)曲线并分析各参数评估Ki-67表达水平的效能。结果Ki-67高表达组病灶动脉期IC、λ_(HU)、CT_(40 keV)均大于Ki-67低表达组(P均<0.05)。两组病灶动脉期参数(NIC、Eff-Z、CT_(70 keV)、CT_(100 keV))及静脉期、延迟期各参数差异均无统计学意义(P均>0.05)。动脉期IC、λ_(HU)、CT_(40 keV)与Ki-67的表达水平呈弱正相关(r_(s)值分别为0.366、0.356、0.346,P均<0.05)。ROC曲线分析表明,动脉期IC诊断效能最高(AUC 0.716,敏感度60.7%,特异度77.8%),其次为动脉期λ_(HU)(AUC 0.710,敏感度60.7%,特异度83.3%)。结论双层探测器光谱CT动脉期定量参数可为术前评估CRC Ki-67表达水平提供更多有用信息,具有一定的临床应用价值。Objective To evaluate the value of quantitative parameters of dual-layer spectral detector CT(SDCT)in evaluating the expression level of Ki-67 antigen in colorectal cancer.Methods Data of 92 patients with colorectal cancer confirmed by surgery and pathology from October 2021 to September 2023 in the First Affiliated Hospital of Kunming Medical University were retrospectively collected.All patients underwent abdominal three-phase enhanced scanning on SDCT.Based on Ki-67 expression level,patients were categorized into either the high-expression group(n=56,Ki-67>50%)or the low-expression group(n=36,Ki-67≤50%).Parameters such as iodine concentration(IC),effective atomic number(Eff-Z),CT_(40 keV),CT_(70 keV),and CT_(100keV)of colorectal cancer lesions through three-phase enhanced scanning were measured.Normalized iodine concentration(NIC)and energy spectrum curve slope(λ_(HU))were calculated.The differences of parameters between the two groups in enhanced scan were compared.Spearman correlation coefficient was used to evaluate the correlation between statistically significant parameters and Ki-67 expression level.The ROC curve was drawn to observe the efficacy of each parameter for predicting Ki-67 expression level.Results Arterial IC,λ_(HU),CT40keV were higher in high expression group than those in low expression group.There were no significant differences in arterial parameters(NIC,Eff-Z,CT_(70 keV),CT_(100keV))and each parameter in venous or delayed stage between the two groups(all P>0.05).There was a weak positive correlation found between arterial IC,λHU,CT_(40 keV)and the expression level of Ki-67(r_(s)=0.366,0.356,0.346,all P<0.05).ROC curve analysis showed that the diagnostic efficiency of arterial IC was the highest(AUC 0.716,sensitivity 60.7%,specificity 77.8%),followed by the arterialλ_(HU)(AUC 0.710,sensitivity 60.7%,specificity 83.3%).Conclusion The SDCT quantitative parameters of arterial phase can provide more useful information for preoperative assessment of the Ki-67 expression level in colorect

关 键 词：结直肠癌 KI-67抗原 计算机体层成像 

分 类 号：R735.34[医药卫生—肿瘤] R730.44[医药卫生—临床医学]