CT纹理分析评估非小细胞肺癌ALK基因状态的价值

The Value of CT Texture Analysis for Predicting ALK Gene Status in Non-Small Cell Lung Cancer Patients

目的:探讨CT纹理分析对非小细胞肺癌(NSCLC)患者的间变性淋巴瘤激酶(ALK)基因状态的预测价值。方法:回顾性收集54例经病理证实的NSCLC患者,其中ALK基因变异者18例,未变异者36例。采用Omni-Kinetics软件对肺癌患者治疗前的增强CT图像进行纹理分析,比较纹理参数在ALK基因变异与未变异组间的差异。采用受试者工作特征(ROC)曲线评估纹理参数的预测效能。结果:ALK变异组中的Mean、Entropy、Grey Level Nonuniformity显著高于未变异组(P=0.003、0.021、0.030),Energy、Sphericity显著低于未变异组(P=0.002、0.030)。CT各纹理参数预测ALK基因状态的ROC曲线下面积(AUC)值在0.673~0.796,CT纹理参数联合后,其AUC值提高至0.853,灵敏度为0.711,特异度为0.972。结论:CT纹理分析可用于预测NSCLC患者的ALK基因突变状态,有望为ALK基因状态的诊断提供辅助信息。

Purpose:To investigate the value of CT texture analysis for predicting anaplastic lymphoma kinase(ALK)gene status in non-small cell lung cancer(NSCLC)patients.Methods:A total of 54 patients with pathologically confirmed NSCLC were retrospectively collected,and divided into ALK mutated group(n=18)and non-mutated group(n=36)according to the ALK gene status.The Omni-Kinetics software was used to perform the texture analysis based on enhanced CT images of lung cancer patients before treatment,and the differences of texture parameters between the two groups with different ALK gene status were compared.The receiver operating characteristic(ROC)curve was used to evaluate the predictive performance of texture parameters.Results:The Mean,Entropy,and Grey Level Nonuniformity in the ALK mutated group were significantly higher than those in non-mutated group(P=0.003,0.021,0.030),and energy and sphericity were significantly lower than those in nonmutated group(P=0.002,0.030).The areas under ROC curve(AUCs)of CT texture parameters for predicting ALK gene status were between 0.673 and 0.796.The AUC of the combination of CT texture parameters was 0.853,with the sensitivity of 0.711 and specificity of 0.972.Conclusion:CT texture analysis can be used to predict the ALK gene status of NSCLC patients,and it is expected to provide auxiliary information for the diagnosis of ALK gene status.