喉和下咽鳞状细胞癌能谱CT定量参数与其EGFR表达水平相关性研究

Correlation between Quantitative Parameters of Spectral CT with the Expression Level of Epidermal Growth Factor Receptor in Laryngeal and Hypopharyngeal Squamous Cell Carcinoma

目的探讨喉和下咽鳞状细胞癌(LHSCC)能谱CT定量参数值与表皮生长因子受体(EGFR)表达水平的相关性及能谱CT定量参数评估LHSCC EGFR表达水平的准确性。方法回顾性分析43例行颈部能谱CT扫描并经活检或手术病理证实为LHSCC的患者资料。用能谱CT后处理软件测量LHSCC的碘浓度(IC)、水浓度(WC)、有效原子序数,并计算标准化碘浓度(NIC)、标准化水浓度(NWC)和能谱曲线斜率(λHU)。采用独立样本t检验分析比较不同EGFR表达水平LHSCC能谱CT定量参数有无差异,将有差异定量参数绘制受试者工作特征(ROC)曲线,并分析其诊断效能。结果EGFR高表达组与低表达组IC分别为(2.22±0.63)mg/ml、(1.68±0.58)mg/ml,NIC分别为0.31±0.09、0.23±0.08,两组间的差异均有统计学意义(P=0.007,P=0.003)。WC、NWC、λHU、有效原子序数在两组间差异无统计学意义(P>0.05)。以IC 1.51 mg/ml作为临界值,曲线下面积(AUC)为0.730,敏感度、特异度分别为95.8%、47.4%;以NIC 0.26作为临界值,AUC为0.781,敏感度、特异度分别为87.5%、68.4%。结论LHSCC的能谱CT定量参数可在一定程度上反映其EGFR表达水平,其中NIC诊断效能最高。

Objective To investigate the correlation between the quantitative parameters of spectral CT and the expression level of epidermal growth factor receptor(EGFR)in laryngeal and hypopharyngeal squamous cell carcinoma(LHSCC)and to evaluate predictive value of the expression level of EGFR.Methods The retrospective study included 43 patients who had underwent cervical spectral CT scan and were confirmed LHSCC by biopsy or surgical pathology.Iodine concentration(IC),water concentration(WC)and effective atomic number of LHSCC were measured by spectral CT post-processing software,and normalized iodine concentration(NIC),normalized water concentration(NWC)and spectral curve slope(λHU)were calculated.Independent sample t-test was used to analyze the difference between quantitative parameters of spectral CT in LHSCC with different EGFR expression levels.The ROC curve was drawn,and the diagnostic efficiency was analyzed.Results The IC value of EGFR high expression group and low expression group were 2.22±0.63 and 1.68±0.58,respectively,and NIC value were 0.31±0.09 and 0.23±0.08,respectively.The differences between the two groups were statistically significant(P=0.007,P=0.003).However,there was no significant difference in WC,NWC,λHU and effective atomic number between the two groups(P>0.05).With IC 1.51 as the threshold,the area under the curve(AUC)was 0.730,and the sensitivity and specificity were 95.8%and 47.4%,respectively.With NIC 0.26 as the threshold,the AUC was 0.781,and the sensitivity and specificity were 87.5%and 68.4%respectively.Conclusion The quantitative parameters of spectral CT are valuable to predict the expression levels of EGFR in LHSCC,and NIC has the highest diagnostic efficiency.