双层探测器光谱CT多参数预测肺腺癌Ki-67指数表达的可行性  

Feasibility of predicting expression of Ki-67 in lung adenocarcinoma via multi-parameter of duallayer spectral detector CT

作　　者：陈怡婷 倪晓琼 徐亮[2] 范国华[2] 金丹[2] CHEN Yiting;NI Xiaoqiong;XU Liang;FAN Guohua;JIN Dan(Suzhou Medical College,Soochow University,Suzhou,Jiangsu Province 215004,China;Department of Imaging Diagnosis,the Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215004,China)

机构地区：[1]苏州大学苏州医学院,江苏苏州215004 [2]苏州大学附属第二医院影像诊断科,江苏苏州215004

出　　处：《实用放射学杂志》2024年第10期1597-1600,1610,共5页Journal of Practical Radiology

基　　金：省部共建放射医学与辐射防护国家重点实验室开放课题(GZK12023041)。

摘　　要：目的探讨光谱CT多参数预测肺腺癌Ki-67指数表达水平的可行性。方法回顾性分析226例经病理证实为肺腺癌患者资料,分析病灶常规及光谱CT参数。根据Ki-67表达水平分为低表达组及高表达组。以差异有统计学意义的参数作为自变量进行多因素logistic回归分析,建立预测Ki-67表达水平的logistic回归模型,采用受试者工作特征(ROC)曲线评估各模型诊断效能。结果临床资料性别、吸烟和胸痛在Ki-67高表达组、低表达组间有显著差异。光谱CT参数中动脉期高表达组的CT_(40 keV)、CT_(100 keV)、有效原子序数(Z_(eff))、碘浓度(IC)均高于低表达组。经logistic回归分析发现CT100 keV为Ki-67表达水平独立危险因素。光谱CT模型和联合模型对肺腺癌Ki-67表达水平预测具有较高价值,联合模型诊断效能更好。结论光谱CT参数联合临床因素对预测肺腺癌Ki-67表达水平具有一定价值。Objective To explore the feasibility of predicting expression level of Ki-67 in lung adenocarcinoma via multi-parameter of spectral CT.Methods The data of 226 patients with lung adenocarcinoma confirmed by pathology were analyzed retrospectively.The conventional and spectral CT parameters of the lesions were analyzed.According to Ki-67 expression level,all patients were divided into low expression group and high expression group.The parameters with statistical significance were identified as independent variables for multivariate logistic regression analysis to establish a logistic regression model for predicting the expression level of Ki-67.Receiver operating characteristic(ROC)curve was used to assess the diagnostic performance for each model,respectively.Results There were significant differences in the clinical factors of gender,smoking and chest pain between high and low Ki-67 expression groups.In spectral CT parameters,CT_(40 keV),CT_(100 keV),Z-effective(Z_(eff))and iodine concentration(IC)in the high expression group in arterial phase were significantly higher than those in the low expression group.Logistic regression analysis showed that CT_(100)keV was the independent risk factor for Ki-67 expression level.Both the spectral CT model and the combined model had high value in predicting the expression level of Ki-67 in lung adenocarcinoma,and the combined model had better diagnostic efficacy.Conclusion Spectral CT parameters combined with clinical factors have a certain value in predicting the expression level of Ki-67 in lung adenocarcinoma.

关 键 词：肺腺癌 KI-67 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]