双能C T联合临床病理特征预测结直肠癌Ki-67表达的价值

Value of Dual-energy CT Combined with Clinicopathological Characteristics in Predicting the Expression of Ki-67 in Colorectal Cancer

目的探讨双能量CT(DECT)定量参数联合临床病理特征预测结直肠癌(CRC)增殖抗原Ki-67阳性表达的价值。方法回顾性收集行腹盆腔DECT双期增强检查且经手术病理证实的123例结直肠腺癌患者术前影像学资料及临床病理资料。根据术后病理结果将Ki-67分为高表达和低表达两组。利用Siemens工作站进行图像后处理,获得入组患者动脉期和静脉期的碘浓度(IC)、标准化碘浓度(NIC)及能谱曲线斜率(λHU)。采用χ^(2)检验比较两组间临床病理资料的差异。采用独立样本t检验/Mann-Whitney U检验比较两组间能谱参数的差异;采用受试者工作特征曲线(ROC)评估有统计学意义的参数的预测效能。结果结直肠癌Ki-67高表达组和低表达组之间血清CA199水平差异有统计学意义(χ^(2)=5.559,P<0.05)。Ki-67高表达组双期IC值、NIC值及能谱曲线斜率均高于Ki-67低表达组,差异具有统计学意义(P<0.05)。结论DECT定量参数IC、NIC、λHU及血清CA199可在一定程度上反映结直肠癌细胞增殖程度,预测结直肠癌Ki-67阳性表达的水平。

Objective To investigate the value of dual-energy CT(DECT)combined with clinicopathological characteristics in predicting the positive expression of proliferating antigen Ki-67 in colorectal cancer(CRC).Methods 123 adenocarcinoma CRC patients proved by pathological examination were postoperatively analysed.All patients underwent baseline abdominal and/or pelvic contrast enhanced dual-energy CT(DECT)scan in our institution.All patients were divided into high expression and low expression group according to the expression of Ki-67,The iodine concentration(IC),normalized iodine concentration(NIC)and slope of energy spectrum curve(λHU)were measured by DECT analysis workstation.Chisquare was used to compare the clinical data and the t/Mann-Whitney U test were used to compare energy spectrum parameters between the two groups.The parameters with statistical significance were analyzed by receiver operating characteristic curve(ROC),and the prediction efficiency of the parameters was evaluated.Results There was significant difference in the serum CA199 levels(χ^(2)=5.559,P<0.05).The biphasic IC,NIC and the slope of energy spectrum curve in Ki-67 high expression group were significantly higher than those in Ki-67 low expression group.Conclusion DECT quantitative parameters IC,NIC,λHU and serum CA199 can reflect the proliferation degree of colorectal cancer cells to some extent and predict the positive expression level of Ki-67 in colorectal cancer.