喉癌甲状软骨侵犯危险因素及基于双能CT碘图喉癌体积诊断甲状软骨侵犯

Analysis of risk factors for thyroid cartilage invasion in laryngeal carcinoma and the value of tumor volume based on DECT derived iodine overlay image in diagnosing thyroid cartilage invasion

目的观察喉癌甲状软骨侵犯的危险因素,分析基于双能CT碘图肿瘤体积对喉癌甲状软骨侵犯的诊断效能。方法回顾性分析经手术病理证实的108例喉癌患者,根据病理结果分为甲状软骨受侵犯组(49例)和未受侵犯组(59例);对比2组基本资料及基于双能CT碘图的肿瘤体积,采用二元Logistic回归方程分析喉癌甲状软骨侵犯危险因素及其诊断喉癌甲状软骨侵犯的效能。结果甲状软骨受侵犯组与未受侵犯组患者性别、年龄、病程及肿瘤分化程度差异均无统计学意义(P均>0.05),喉癌分型、前联合侵犯及基于双能CT碘图的肿瘤体积差异均有统计学意义(P均<0.01)。Logistic回归分析结果显示,基于碘图的肿瘤体积(P<0.01)和前联合侵犯(P=0.03)是喉癌甲状软骨侵犯的危险因素;以肿瘤体积=3.91 cm3为临界值诊断甲状软骨侵犯的敏感度及特异度分别为93.90%及89.80%,Youden指数为0.84,AUC为0.97[95%CI(0.94,0.99),P<0.01]。结论基于双能CT碘图的肿瘤体积和前联合侵犯是喉癌甲状软骨侵犯的危险因素;基于双能CT碘图的肿瘤体积可用于诊断甲状软骨侵犯。

Objective To investigate the risk factors associated with thyroid cartilage invasion in laryngeal carcinoma,and to analyze the efficacy of tumor volume based on dual-energy CT(DECT)derived iodine overlay image for diagnosing thyroid cartilage invasion.Methods Totally 108 patients with laryngeal squamous cell carcinoma confirmed by pathology were retrospectively analyzed.The patients were divided into thyroid cartilage invasion group(n=49)and non-invasion group(n=59).The clinic data and the tumor volume based on DECT derived iodine overlay image were compared.The risk factors related to thyroid cartilage invasion in laryngeal carcinoma were analyzed using binary Logistic regression,and the efficacy of each risk factor in diagnosing thyroid cartilage invasion was further analyzed.Results No significant difference in gender,age,disease duration and tumor differentiation between thyroid cartilage invasion group and non-invasion group(all P>0.05),while the clinical type of tumor,anterior commissure involvement and tumor volume were significantly different between the two groups(all P<0.01).The Logistic regression analysis showed that tumor volume based on iodine overlay image(P<0.01)and anterior commissure involvement(P=0.03)were risk factors of thyroid cartilage invasion.Taking the tumor volume=3.91 cm3 as the cutoff value,the sensitivity and specificity for the diagnosis of thyroid cartilage invasion were 93.90%and 89.80%,with the Youden index of 0.84 and AUC of 0.97(95%CI[0.94,0.99],P<0.01),respectively.Conclusion Tumor volume based on DECT derived iodine map and anterior commissure invasion are risk factors for thyroid cartilage invasion in laryngeal carcinoma.Tumor volume based on DECT derived iodine map can be used to diagnose thyroid cartilage invasion.