MSCT技术在结直肠癌腹腔镜根治术预后评估中的应用  

Application of MSCT Technique in Prognosis Assessment of Patients with Colorectal Cancer after Laparoscopic Radical Surgery

作　　者：李永泉 李凌寒 段超 罗春 LI Yong-quan;LI Ling-han;DUAN Chao;LUO Chun(Department of Radiology,Changsha Hospital of Traditional Chinese Medicine(Changsha Eighth Hospital),Changsha 410100,Hunan Province,China)

机构地区：[1]长沙市中医医院(长沙市第八医院)放射科,湖南长沙410100

出　　处：《中国CT和MRI杂志》2025年第3期168-170,共3页Chinese Journal of CT and MRI

基　　金：湖南省卫生健康委科研计划项目(No.202304076698)。

摘　　要：目的探讨多层螺旋CT(MSCT)灌注参数在结直肠癌(CRC)患者腹腔镜根治术预后评估中的应用。方法回顾性分析我院于2022年12月至2024年6月接受诊治的共计126例CRC患者的临床资料,所有患者均行腹腔镜结直肠癌根治术,并对患者进行长达2年的随访观察,依据随访结果将患者划分成预后不良组(n=53)和预后良好组(n=73)。比较两组基础资料信息及MSCT灌注参数[血容量(BV)、血流量(BF)、达峰时间(TTP)、表面通透性(PS)],采用多因素Logistic回归分析CRC患者腹腔镜根治术后预后不良的危险因素,绘制ROC曲线评估BF、TTP及PS预测CRC患者腹腔镜根治术后预后不良的效能。结果预后不良组TNM分期为Ⅲ~Ⅳ期患者、肿瘤分化程度为低分化患者占比及TTP、PS值显著高于预后良好组,BF值显著低于预后良好组(P<0.05);经多因素Logistic回归分析证实,TNM分期为Ⅲ~Ⅳ期、肿瘤分化程度为低分化、BF数值降低、TTP及PS数值升高是CRC患者腹腔镜根治术后预后不良的独立危险因素(P<0.05);经ROC分析证实,BF、TTP及PS均可用于CRC患者腹腔镜根治术后预后不良的评估,曲线下面积分别为0.931、0.868、0.900,均有P<0.05。结论TNM分期为Ⅲ~Ⅳ期、肿瘤分化程度为低分化、BF数值降低、TTP及PS数值升高会影响CRC患者腹腔镜根治术后预后不良,且MSCT灌注参数对评估CRC患者腹腔镜根治术预后具有一定价值,临床上应引起重视。Objective To investigate the application of multi-slice spiral CT(MSCT)perfusion parameters in the prognosis assessment of patients with colorectal cancer(CRC)after laparoscopic radical surgery.Methods Clinical data of 126 CRC patients treated in our hospital from December 2022 to June 2024 were retrospectively analyzed.All patients underwent laparoscopic radical resection of colorectal cancer,and were followed up for 2 years.According to the follow-up results,patients were divided into poor prognosis group(n=53)and good prognosis group(n=73).The basic data information and MSCT perfusion parameters[blood volume(BV),blood flow(BF),peak time(TT P),Surface permeability(PS)]of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in CRC patients after laparoscopic radical surgery,and ROC curve was drawn to evaluate the efficacy of BF,TT P and PS in predicting poor prognosis in CRC patients after laparoscopic radical surgery.Results The proportion of patients with TNM stageⅢ~Ⅳ,poorly differentiated tumor,TT P and PS values in poor prognosis group was significantly higher than that in good prognosis group,and BF value was significantly lower than that in good prognosis group(P<0.05).Multivariate Logistic regression analysis confirmed that TNM stageⅢ~Ⅳ,tumor differentiation degree low differentiation,BF value decreased,TT P and PS value increased were independent risk factors for poor prognosis of CRC patients after laparoscopic radical surgery(P<0.05).ROC analysis confirmed that BF,TT P and PS could all be used to evaluate the poor prognosis of CRC patients after laparoscopic radical surgery,and the areas under the curve were 0.931,0.868 and 0.900,respectively,with P<0.05.Conclusion TNM stageⅢ~Ⅳ,tumor differentiation degree low differentiation,BF value decreased,TT P and PS value increased will affect the poor prognosis of CRC patients after laparoscopic radical surgery,and MSCT perfusion parameters have certain value in evaluating the prognosis

关 键 词：结直肠癌 腹腔镜结直肠癌根治术 多层螺旋CT 灌注参数 预后 

分 类 号：R735.37[医药卫生—肿瘤]