能谱CT碘基图直方图分析预测胃间质瘤Ki-67表达水平的价值  

Value of spectral CT iodine map histogram analysis in predicting Ki-67 expression in gastric stromal tumors

作　　者：刘显旺 谢一婧 刘宏[1] 韩涛 邓娟 薛彩强 李昇霖 周俊林[1] LIU Xian-wang;XIE Yi-jing;LIU Hong;HAN Tao;DENG Juan;XUE Cai-qiang;LI Sheng-lin;ZHOU Jun-lin(Department of Radiology,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030

出　　处：《中国临床医学影像杂志》2025年第4期260-264,274,共6页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金(82260361);兰州大学第二医院“萃英科技创新”计划应用基础研究-重点培育项目(CY2021-ZD-01);兰州大学第二医院“萃英科技创新”计划青年项目(CY2022-QN-A10)。

摘　　要：目的:探讨能谱CT碘基图直方图分析在术前预测胃间质瘤(GST)Ki-67表达水平中的价值。方法:回顾性收集57例经手术病理证实并测定Ki-67表达水平的GST患者,其中Ki-67低水平表达组29例(Ki-67<10%),Ki-67高水平表达组28例(Ki-67≥10%)。所有患者均在术前接受腹部能谱CT成像,使用FireVoxel软件在静脉期碘基图上勾画肿瘤并进行直方图参数提取,提取的参数包括最小值,最大值,平均值,第1、25、50、75、99百分位数,标准差,变异度,变异系数,偏度、峰度和熵。比较两组肿瘤间碘基图直方图参数间的差异。采用Logistic回归将碘基图直方图参数进行联合,绘制受试者操作特性曲线评估各参数的诊断性能。碘基图直方图参数与Ki-67表达水平间的关系采用Spearman相关分析进行评价。结果:GST Ki-67高水平表达组的最大值,第99百分位数,熵均高于Ki-67低水平表达组(P<0.00357),且最大值(r=0.680),第99百分位数(r=0.604),熵(r=0.319)和Ki-67表达水平间呈明显的正相关性(P<0.05)。各参数均能在术前对两组肿瘤进行有效区分。联合最大值,第99百分位数和熵的联合变量的预测效能最佳,AUC值为0.872。结论:能谱CT碘基图直方图分析能在术前有效预测GST Ki-67表达水平,碘基图直方图参数的联合分析可获得更高的预测效能。Objective:To explore the value of spectral CT iodine map histogram analysis in predicting Ki-67 expression in gastric stromal tumors(GST).Methods:A total of 57 GST patients in whom Ki-67 expression was measured were retrospectively enrolled,including 29 cases in the low Ki-67 expression group(Ki-67<10%)and 28 cases in the high Ki-67 expression group(Ki-67≥10%).All patients underwent abdominal spectral CT imaging before surgery.FireVoxel software was used to outline the tumors on the iodine map of venous phase and extract histogram parameters,including minimum,maximum,mean,1st,25th,50th,75th,and 99th percentiles,standard deviation,variation,coefficient of variation,skewness,kurtosis,and entropy.The difference in iodine map histogram parameters between the two groups was compared.Logistic regression was used to combine the iodine map histogram parameters.The receiver operating characteristic curve was constructed to evaluate the diagnostic performance of each parameter.Spearman correlation analysis was used to evaluate the relationship between the iodine histogram parameters and Ki-67 expression levels.Results:The maximum,99th percentile,and entropy of the GST Ki-67 high expression group were higher than those of the Ki-67 low expression group(P<0.00357)and there was a significant positive correlation between the maximum(r=0.680),99th percentile(r=0.604),entropy(r=0.319)and Ki-67 expression(P<0.05).All parameters can effectively differentiate the two groups of tumors before surgery.The combined variable(combined maximum,99th percentile,and entropy)showed the best predictive performance with an AUC of 0.872.Conclusion:Spectral CT iodine map histogram analysis was effective in predicting Ki-67 expression of GST before surgery,and the combined analysis of iodine map histogram parameters can achieve higher predictive performance.

关 键 词：胃肿瘤 KI-67抗原 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]