多层螺旋CT联合白蛋白与碱性磷酸酶比值对食管癌T分期的诊断价值

Diagnostic value of multi-slice spiral CT combined with albumin-toalkaline phosphatase ratio in T staging of esophageal cancer

目的 探讨多层螺旋CT(MSCT)联合白蛋白(ALB)与碱性磷酸酶(ALP)比值(AAPR)对食管癌T分期的诊断价值。方法 选取2018年1月—2023年7月武进中医医院收治的80例食管癌患者。所有受试者行MSCT扫描并检测ALB、ALP、AAPR水平,以AAPR=0.4为分界点,分为低AAPR组(≤0.4)和高AAPR组(> 0.4)。以病理结果为金标准,分析MSCT、AAPR诊断食管癌的受试者工作特征(ROC)曲线。结果 高AAPR组的T分期高于低AAPR组(P <0.05)。MSCT与病理学诊断的T分期比较,差异无统计学意义(P>0.05)。MSCT诊断食管癌T分期的敏感性为86.00%(95%CI:0.807,0.891),特异性为80.00%(95%CI:0.761,0.851);AAPR诊断食管癌T分期的敏感性为79.00%(95%CI:0.753,0.845),特异性为71.20%(95%CI:0.697,0.757);MSCT联合AAPR诊断食管癌T分期的敏感性为93.00%(95%CI:0.783,0.971),特异性为90.51%(95%CI:0.842,0.921)。MSCT联合AAPR的诊断效能均优于单独诊断,且MSCT、两者联合诊断食管癌T分期的价值均较高(曲线下面积> 0.9)。结论 MSCT联合AAPR对食管癌T分期有诊断价值,值得临床推广。

Objective To investigate the diagnostic efficacy of multi-slice spiral CT(MSCT)combined with albumin(ALB)-to-alkaline phosphatase(ALP)ratio(AAPR)in T staging of esophageal cancer.Methods A total of 80 patients with esophageal cancer admitted to Wujin Traditional Chinese Medicine Hospital from January 2018 to July 2023 were selected.All participants underwent MSCT scan and were tested for the levels of ALB,ALP and AAPR.With the pathological findings as the gold standard,the receiver operating characteristic(ROC)curves of MSCT and AAPR for diagnosing esophageal cancer were analyzed.Results The T stage of the low AAPR group was higher than that of the high AAPR group(P<0.05).There was no significant difference in the T staging between the MSCT diagnosis and the pathological diagnosis(P>0.05).The sensitivity of MSCT in the diagnosis of the T stage of esophageal cancer was 86.00%(95%CI:0.807,0.891),with the specificity being 80.00%(95%CI:0.761,0.851).The sensitivity and specificity of AAPR in the diagnosis of the T stage of esophageal cancer were 79.00%(95%CI:0.753,0.845)and 71.20%(95%CI:0.697,0.757),respectively.The sensitivity and specificity of MSCT combined with AAPR in the diagnosis of the T stage of esophageal cancer were 93.00%(95%CI:0.783,0.971)and 90.51%(95%CI:0.842,0.921).The diagnostic efficacy of MSCT combined with AAPR was higher than that of MSCT and that of AAPR alone,and the values of MSCT and MSCT combined with AAPR for diagnosing the T stage of esophageal cancer were higher(area under the curve>0.9).Conclusion MSCT combined with AAPR is of value in the diagnosis of the T stage of esophageal cancer,and could be widely adopted in clinical practice.