Spectral computed tomography parameters of primary tumors and lymph nodes for predicting tumor deposits in colorectal cancer  

作　　者：Yi-Fan Lai Zhao-Ming Liang Jing-Fang Li Jia-Ying Zhang Ding-Hua Xu Hai-Yang Dai 

机构地区：[1]The First Clinical College,Guangdong Medical University,Zhanjiang 524023,Guangdong Province,China [2]Department of Radiology,Huizhou Central People’s Hospital,Huizhou 516001,Guangdong Province,China

出　　处：《World Journal of Radiology》2025年第4期12-21,共10页世界放射学杂志(英文)

摘　　要：BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of life.However,the detection of TDs relies primarily on postoperative pathological examination,which may have a low detection rate due to sampling limitations.AIM To evaluate the spectral computed tomography(CT)parameters of primary tu-mors and the largest regional lymph nodes(LNs),to determine their value in predicting TDs in CRC.METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available.Patients were divided into the TDs+group and the TDs-group on the basis of their pathological results.Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured,including the normalized iodine concentration(NIC)in both the arte-rial and venous phases,and the LN-to-primary tumor ratio was calculated.Stati-stical methods were used to evaluate the diagnostic efficacy of each spectral para-meter.RESULTS Among the 121 CRC patients,33(27.2%)were confirmed to be TDs+.The risk of TDs positivity was greater in patients with positive LN metastasis,higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels.The NIC(LNs in both the arterial and venous phases),NIC(primary tumors in the venous phase),and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs(P<0.05).In mul-tivariate logistic regression analysis,the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs,demonstrating the highest diagnostic performance(area under the curve:0.812,sensitivity:0.879,specificity:0.648,cutoff value:1.145).CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs,especially the LN-to-primary tumor ratio,have significant clinical value in predicting TDs in CRC.

关 键 词：Spectral computed tomography Colorectal cancer Tumor deposits Predicting effectiveness 

分 类 号：R73[医药卫生—肿瘤]