FORCE CT对结直肠癌术前N分期的评估价值研究

Evaluation value of FORCE CT parameters in preoperative N staging of colorectal cancer

目的 探讨FORCE CT对结直肠癌术前N分期的评估价值。方法 选取我院经病理证实的结直肠癌患者116例为观察对象,均采用FORCE CT检查,拟行手术治疗。对比不同N分期患者淋巴结CT值(动脉期、门静脉期),分析N分期的临床各影响因素,绘制受试者工作特征曲线(ROC),分析CT值对N分期的评估价值。结果 116例患者术后经病理证实N0期67例、N1期30例、N2期19例,随着N分期增加,患者CT值增加,中高分化及肿瘤下缘距肛缘距离≤10cm比例降低,血清CEA、CA199水平升高,差异有统计学意义(P<0.05);有序多分类Logistic回归模型,校正分化程度、肿瘤下缘距肛缘距离后,CT值仍为结直肠癌患者N分期的独立相关因素(P<0.05);绘制ROC曲线显示,动脉期、门静脉期CT值联合鉴别结直肠癌患者N0、N1分期的AUC值为0.853,大于动脉期或门静脉期CT值单独鉴别,差异有统计学意义(P<0.05);动脉期、门静脉期CT值联合鉴别结直肠癌患者N1、N2分期的AUC值为0.907,大于动脉期或门静脉期CT值单独鉴别,差异有统计学意义(P<0.05)。结论 FORCE CT参数与结直肠癌术前N分期变化关系密切,在术前N分期的评估中具有较高价值。

Objective To investigate the evaluation value of FORCE CT parameters for preoperative N staging of colorectal cancer.Methods A total of 116 patients with pathologically confirmed colorectal cancer in our hospital were selected for observation,and all of them were examined by FORCE CT for surgical treatment.The CT values of lymph nodes(arterial phase and portal stage)of patients with different N stages were compared,the clinical influencing factors of N stage were analyzed,the subject operating characteristic curve(ROC)was plotted,and the evaluation value of CT value on N stage was analyzed.Results In 116 patients,67 patients in N0 stage,30 cases in N1 stage and 19 patients in N2 stage were examined by pathological examination,with the increase of N stage,the CT value of the patients increased,the proportion of medium and high differentiation and the distance between the lower edge of the tumor and the margin≤10 cm decreased,and the serum CEA and CA199 levels increased(P<0.05).The CT value was still an independent correlation factor for the N stage of colorectal cancer patients(P<0.05),and the AUC value of the combination of CT values in arterial phase and portal vein phase in differentiating N0 and N1 stages of colorectal cancer patients was 0.853,which was greater than that of CT values in arterial phase or portal vein phase alone(P<0.05),and the AUC value of arterial stage and portal vein stage combined with the identification of N1 and N2 stages of colorectal cancer was 0.907,which was greater than that of CT values in arterial phase or portal vein phase alone(P<0.05).Conclusion FORCE CT parameter is closely related to the changes of preoperative N staging of colorectal cancer,and it has high value in the evaluation of preoperative N staging.