胃癌CT纹理分析在TNM分期中的应用研究

Application of CT texture analysis in TNM staging of gastric cancer

目的:探讨并分析胃癌计算机断层扫描(CT)纹理分析在TNM分期中的应用。方法:回顾性分析确诊的153例胃腺癌患者,所有患者术前均行CT检查,利用纹理分析软件测量提取动脉期和静脉期CT图像的纹理参数,并比较动脉期和静脉期中TNM分期的平均CT值、最大频率、偏度值、峰度值及熵值变化,采用Pearson相关性分析T分期与CT纹理参数的关系;采用受试者工作曲线(ROC)评价CT纹理参数对N分期的评估效能。结果:动脉期中T_(1)组的最大频率显著低于T_(2-4)组,偏度值高于T_(2-4)组(均P<0.05);静脉期中T_(1)组的最大频率及峰度值均显著低于T_(2-4)组,偏度值高于T_(2-4)组(均P<0.05);Pearson相关性分析显示,T分期与动脉期最大频率、静脉期最大频率及峰度值呈正相关关系,与动脉期偏度值、静脉期偏度值呈负相关关系(均P<0.05);动脉期中N_(0)组的最大频率显著低于N_(1-3)组,偏度值及峰度值高于N_(1-3)组(均P<0.05);静脉期中N_(0)组的最大频率及峰度值均显著低于N_(1-3)组,偏度值高于N_(1-3)组(均P<0.05),动脉期最大频率、偏度值及峰度值评估N分期的AUC分别为0.737、0.726及0.718;静脉期最大频率、偏度值及峰度值的AUC分别为0.735、0.711及0.720(均P<0.05)。结论:CT纹理分析可有效评估胃癌TNM分期,指导临床治疗。

Objective:To explore and analyze the application of computed tomography(CT)texture analysis in TNM staging of gastric cancer.Methods:A retrospective analysis was performed on the 153 patients with gastric adenocarcinoma.All patients underwent CT examination before surgery.The texture parameters of CT images in the arterial and venous phases were measured by texture analysis software.The changes in mean CT value,the maximum frequency,skewness,kurtosis and entropy of TNM staging in arterial and venous stages were compared.The relationship between T staging and CT texture parameters was analyzed by Pearson correlation analysis.The evaluation efficiency of CT texture parameters for N staging was assessed by receiver operating characteristic(ROC)curve.Results:In arterial phase,the maximum frequency in T_(1) group was significantly lower than that in T_(2-4) group,while skewness value was greater than that in T_(2-4) group(all P<0.05).In venous phase,the maximum frequency and kurtosis in T_(1) group were significantly lower than those in T_(2-4) group,while skewness value was greater than that in T_(2-4) group(all P<0.05).Pearson correlation analysis showed that T staging was positively correlated with the maximum frequency in arterial phase and venous phase,kurtosis in venous phase,while negatively correlated with skewness values in arterial and venous phases(all P<0.05).In arterial phase,the maximum frequency in N_(0) group was significantly lower than that in N_(1-3) group,while skewness and kurtosis values were greater than those in N_(1-3) group(all P<0.05).In venous phase,the maximum frequency and kurtosis in N_(0) group were significantly lower than those in N_(1-3) group,while skewness value was greater than that in N_(1-3) group(all P<0.05).AUC values of the maximum frequency,skewness and kurtosis in arterial phase for assessing N staging were 0.737,0.726 and 0.718 respectively,and AUC values of the maximum frequency,skewness and kurtosis in venous phase for assessing N staging were 0.735,0.711 and 0.720,respectively(all P<0.05).Conclusion:CT texture analysis can effectively assess TNM staging of gastric cancer and guide clinical treatment.