宝石能谱CT对肺鳞癌分化程度的评估价值分析

Value analysis of gemstone energy spectrum CT in evaluating the differentiation degree of lung squamous cell carcinoma

目的探讨宝石能谱CT对肺鳞癌分化程度评估的应用价值。方法回顾性分析河南大学第一附属医院收治的86例行宝石能谱CT双期扫描的肺鳞癌患者的资料,根据病理学标准分为低分化、中分化和高分化,其中低分化18例,记为A组,中分化42例,记为B组,高分化26例,记为C组。对比静脉期、动脉期不同分化程度肺鱗癌宝石能谱CT成像参数,并以受试者工作特征(Receiver Operating Characteristic,R0C)曲线分析动脉期宝石能谱CT成像各参数评估低分化、中分化和高分化肺鱗癌的效能。结果3组静脉期肺鱗癌宝石能谱CT成像各参数及动脉期水浓度比较差异均无统计学意义(P>O.05);动脉期A组和B组的碘浓度、标准化碘浓度(Normalized Iodine Concentration,NIC)、斜率A:值绝对值和有效原子系数高于C组(P<0.05),且A组均高于B组(P<0.05);经ROC分析显示,碘浓度、NIC、斜率尺值和有效原子系数联合评估低分化肺鱗癌的灵敏度、特异度、曲线下面积(Area Under Curve,AUC)分别为72.22%、97.06%和0.905,联合评估中分化肺鱗癌的灵敏度、特异度、AUC分别为78.57%、95.45%和0.930,联合评估高分化肺鳞癌的灵敏度、特异度、AUC分别为76.92%、96.67%和0.908,且特异度和AUC均最高。结论宝石能谱CT各参数对于评估动脉期肺鱗癌分化程度具有重要价值,且碘浓度、水浓度、NIC、斜率K值和有效原子系数联合评估动脉期肺鳞癌分化程度的效能较单一参数更为准确。

Objective To explore the application value of gemstone energy spectral CT in evaluating the differentiation degree of lung squamous cell carcinoma.Methods The data of 86 cases of patients with lung squamous cell carcinoma who underwent gemstone energy spectral CT scanning were retrospectively analyzed,according to pathological criteria,they were divided into low differentiation,medium differentiation and high differentiation,among them,18 cases were poorly differentiated,which were classified as group A,42 cases were moderately differentiated,and were classified as group B,26 cases were high differentiation,and were classified as group C.The CT imaging parameters of the gemological energy spectrum of lung squamous cell carcinoma with different degrees of differentiation in the venous phase and arterial phase were compared,and the parameters of the CT imaging of the gemological spectrum of the arterial phase to evaluate the efficacy of poorly differentiated,moderately differentiated and well differentiated lung squamous cell carcinoma were analyzed by receiver operating characteristic(ROC)curve.Results There were no statistically significant difference in the parameters of CT imaging of gemstone energy spectrum of lung squamous cell carcinoma in venous phase and the water concentration in arterial phase among the three groups(P>0.05).The iodine concentration,normalized iodine concentration(NIC),absolute value of slope K value and effective atomic coefficient in arterial phase of group A and group B were higher than group C(P<0.05),of which group A were higher than group B(P<0.05).ROC analysis showed that the sensitivity,specificity and area under curve(AUC)of iodine concentration,NIC,slope K value and effective atomic coefficient to combined evaluate the poorly differentiated lung squamous cell carcinoma were 72.22%,97.06%and 0.905 respectively,which were 78.57%,95.45%and 0.930 respectively to combined evaluate the moderately differentiated lung squamous cell carcinoma,which were 76.92%,96.67%and 0.908 respectively to combined evaluate the highly differentiated lung squamous cell carcinoma,and the specificity and AUC were the highest.Conclusions The parameters of gemstone energy spectrum CT might be great value in assessing the differentiation of pulmonary squamous cell carcinoma in the arterial phase,and the combination of iodine concentration,water concentration,NIC,slope K value and effective atomic coefficient is more accurate than single parameter for evaluating the differentiation of pulmonary squamous cell carcinoma in arterial phase.