增强CT多参数预测结直肠癌错配修复蛋白状态

Multi-parameters in contrast-enhanc CT predicted mismatch repair protein status of colorectal cancer

目的探究增强CT术前预测结直肠癌错配修复蛋白(mismatch repair protein,MRP)表达状态的价值。方法选取161例结直肠癌术前CT平扫及增强图像,评估13个形态学特征及8个定量参数。形态学特征采用2检验,单组内样本量<5时,采用Fisher精确性检验,定量参数采用Mann-Whitney U检验,应用ROC曲线分析CT参数预测MRP表达状态的诊断效能。结果多个CT参数在结直肠癌微卫星不稳定(microsatellite instability,MSI)及MRP不同状态组间有显著差异(P<0.05)。ROC曲线分析表明平扫CT值预测MSH2阴性状态效能最佳(AUC=0.838)。结论多个CT形态学特征或定量参数在结直肠癌MSI、MSH2和PMS2不同状态组间有显著差异。增强CT形态学特征联合定量参数也许可以为术前预测MSI及相关MRP表达状态提供帮助。

Objective To investigate the value of contrast-enhanced CT(CECT)in predicting the mismatch repair protein(MRP)status of colorectal cancer preoperatively.Methods Non-CECT and CECT images of 161 patients were analyzed retrospectively.A total of 13 CT morphological characteristics and 8 quantitative parameters were evaluated.The difference test of morphological characteristics used 2 test,and Fisher accuracy test was used when samples in a single group were less than 5.The difference test of quantitative parameters used Mann-Whitney U test.The diagnostic performance of CT parameters in predicting mismatch repair protein status was analyzed using receiver operating characteristic(ROC)curve analysis.Results There were significant differences of multiple CT parameters in different MSI and MRP groups of colorectal cancer(P<0.05).ROC analysis showed that the diagnostic efficiency of non-CECT value was highest in predicting MSH2 status(AUC=0.838).Conclusion There are significant differences of multiple morphological characteristics or quantitative parameters in different MSI,MSH2,and PMS2 groups of colorectal cancer.Morphological characteristics combined with quantitative parameters in CECT may be useful for predicting the MSI and the related MRP status of colorectal cancer preoperatively.