光谱CT定量参数联合临床及CT特征预测结直肠癌侵犯脉管  

Spectral CT quantitative parameters combined with clinical and CT features for predicting lymphovascular invasion of colorectal cancer

作　　者：李鹏强 刘念军 张潇月 王彦斐 兰金辉 任虎玲 王婧 窦郁[2] 雷军强[2] LI Pengqiang;LIU Nianjun;ZHANG Xiaoyue;WANG Yanfei;LAN Jinhui;REN Huling;WANG Jing;DOU Yu;LEI Junqiang(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;Department of Radiology,the First Hospital of Lanzhou University,Lanzhou 730000,China;Clinical Science,Philips Healthcare,Xi'an 710065,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院放射科,甘肃兰州730000 [3]飞利浦医疗临床科研部,陕西西安710065

出　　处：《中国医学影像技术》2025年第2期286-290,共5页Chinese Journal of Medical Imaging Technology

基　　金：兰州大学第一医院2023年度院内基金(ldyyyn2023-89)。

摘　　要：目的探讨光谱CT定量参数联合临床及CT特征预测结直肠癌侵犯脉管(LVI)的价值。方法回顾性分析98例结直肠癌临床、病理及术前腹部光谱CT资料,根据病理结果将其分为LVI组(n=36)与无LVI组(n=62)。以单因素及多因素logistic回归分析对比组间临床、病理、常规CT表现及光谱CT定量参数,筛选结直肠癌LVI的独立预测因素并构建回归模型。绘制受试者工作特征(ROC)曲线,评估各单一独立预测因素及回归模型预测结直肠癌LVI的效能。结果血清糖类抗原724,CT显示肠周脂肪浸润和病灶静脉期有效原子序数(Zeff)均为结直肠癌LVI的独立预测因素(OR=4.723、7.301、18.912,P均<0.05),其曲线下面积(AUC)分别为0.582、0.723及0.691,而回归模型的AUC为0.837。结论光谱CT定量参数联合临床及CT特征能有效预测结直肠癌LVI。Objective To explore the value of spectral CT quantitative parameters combined with clinical and CT features for predicting lymphovascular invasion(LVI)of colorectal cancer.Methods Clinical,pathological and preoperative abdominal spectral CT data of 98 colorectal cancer patients were retrospectively analyzed.According to pathological results,the patients were divided into LVI group(n=36)and non-LVI group(n=62).Univariate and multivariate logistic regression were used to compared clinical,pathological,conventional CT manifestations and spectral CT quantitative parameters between groups to screen independent predictors for LVI of colorectal cancer,and then a regression model was constructed.Receiver operating characteristic(ROC)curves were drawn,and the area under the curves(AUC)were calculated to evaluate the predictive efficacy of each single independent predictor and regression model for predicting LVI of colorectal cancer.Results Serum carbohydrate antigen 724,CT showed periintestinal fat infiltration and effective atomic number(Zeff)at venous phase were all independent predictors of LVI of colorectal cancer(OR=4.723,7.301 and 18.912,all P<0.05).AUC of the above independent predictors was 0.582,0.723 and 0.691,respectively,while of the regression model was 0.837.Conclusion Spectral CT quantitative parameters combined with clinical and CT features could effectively predict LVI of colorectal cancer.

关 键 词：结直肠肿瘤 体层摄影术 X线计算机 脉管侵犯 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学] R814.42