能谱CT参数预测中晚期非小细胞肺癌EGFR基因突变表达的价值

The value of energy spectrum CT parameters in predicting EGFR gene mutation expression in advanced non-small cell lung cancer

目的探讨能谱CT参数预测中晚期非小细胞肺癌表皮生长因子受体(EGFR)基因突变表达的价值。方法选取符合标准的79例患者分为EGFR基因表达阳性组与阴性组,比较两组间动脉期及静脉期的能谱参数指标,并采用ROC曲线分析能谱参数指标预测EGFR基因表达的效能。结果79例患者EGFR基因表达阳性者32例,阴性者47例。1)动脉期NIC、λHU、70 keV单能量水平对应的CT值在两组间差异有统计学意义(t=3.528,P=0.001;t=4.534,P<0.05;t=3.028,P=0.004);动脉期NWC、有效原子序数在两组间的差异无统计学意义(t=-0.275;P=0.784;t=-0.434;P=0.666);2)静脉期NIC、λHU、70 keV单能量水平对应的CT值在两组间差异有统计学意义(t=3.3,P=0.001;t=3.874,P<0.001;t=3.031,P=0.003);NWC、有效原子序数在两组之间的差异无统计学意义(t=0.51,P=0.612;t=-0.395,P=0.694);3)比较两组增强前后CT值差值ΔCT值,显示动脉期ΔCT值在两组之间的差异无统计学意义(t=1.848,P=0.068),静脉期ΔCT值在两组之间的差异具有统计学意义(t=3.14,P=0.002);4)ROC曲线分析能谱参数指标预测EGFR基因表达的效能,显示静脉期NIC的曲线下面积大于其他能谱参数的曲线下面积,其曲线下面积为0.884(P<0.001),灵敏度为80.9%,特异度为95.90%。结论能谱参数指标在预测EGFR基因表达方面有价值,并且以静脉期NIC的效能较高。

Objective To explore the value of energy spectrum CT parameters in the prediction of EGFR gene mutation expression in advanced non-small cell lung cancer.Methods 79 patients were divided into EGFR gene expression positive group and EGFR gene expression negative group.Results The expression of EGFR gene was positive in 32 cases and negative in 47 cases.1)CT values of NIC,λHU and 70 keV in arterial phase were significantly different between the two groups(t=3.528,P=0.001;t=4.534,P<0.05;t=3.028,P=0.004);There was no significant difference in NWC and effective atomic number between the two groups(t=-0.275;P=0.784;t=-0.434;P=0.666);2)The CT values of NIC,λHU and 70 keV in venous phase were significantly different between the two groups(t=3.3,P=0.001;t=3.874,P<0.001;t=3.031,P=0.003);There was no significant difference in NWC and effective atomic number between the two groups(t=0.51,P=0.612;t=-0.395,P=0.694);3)Comparing the CT value difference between the two groups before and after enhancement,the difference between the two groups was not statistically significant(t=1.848,P=0.068),while the difference between the two groups was statistically significant(t=3.14,P=0.002);and 4)ROC curve analysis showed that the area under curve of NIC in venous phase was larger than that under curve of other parameters.The area under curve was 0.884(P<0.001),the sensitivity was 80.9%,and the specificity was 95.90%.Conclusion The parameters of energy spectrum are valuable in the prediction of EGFR gene expression,and NIC is more effective in venous phase.