摘要
目的:探究光谱CT量化参数评估结直肠癌病理特征及预测其不良预后的价值。方法:选取2020年1月-2023年8月我院收治的117例结直肠癌患者作为研究对象,随访1年后根据预后情况将其分为预后良好组与预后不良组,所有患者均进行光谱CT检查,比较两组患者光谱CT量化参数并绘制受试者工作特征(ROC)曲线分析其对于患者预后不良的预测价值。结果:117例中49例(41.88%)未复发且死亡,其余68例(58.12%)复发或死亡(其中复发59例,死亡9例);两组TNM分期、淋巴结转移比较具有显著性差异(P<0.05);预后不良组能谱曲线斜率、静脉期碘浓度(IC),静脉期标准化碘浓度(NIC)高于预后良好组(P<0.05),两组动脉期IC、动脉期NIC、动脉期有效原子序数,静脉期有效原子序数比较未见显著性差异(P>0.05);光谱CT参数对于结直肠癌患者不良预后进行预测,以静脉期NIC的曲线下面积(AUC)最高,为0.974(95%CI:0.927~0.995),敏感度、特异度分别为85.29%、97.96%(P<0.05);以能谱曲线斜率的AUC最低,为0.608(95%CI:0.514~0.697),敏感度、特异度分别为25.00%、95.92%(P<0.05);四种指标联合后的AUC为0.912(95%CI:0.846~0.957),敏感度为92.65%,特异度为89.80%(P<0.05)。结论:不同预后情况的结直肠癌患者TNM分期及淋巴结转移情况存在差异,光谱CT量化参数对结直肠癌患者不良预后具有较好的预测价值,且以静脉期NIC的预测效能最佳,多种指标联合后敏感度获显著提升,临床可将光谱CT量化参数作为预测结直肠癌患者不良预后的辅助指标。
Objective:To investigate the value of quantitative parameters of spectral CT in evaluating pathological features of colorectal cancer and predicting poor prognosis.Methods:A total of 117 patients with colorectal cancer who were admitted to the hospital from January 2020 to August 2023 were selected as the research subjects,and their general information was analyzed.After one-year fllow-up,they were divided into good prognosis group and poor prognosis group according to the prognosis.All patients underwent spectral CT examination,and quantitative parameters of spectral CT were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to analyze the value of these parameters in predicting poor prognosis.Results:Among the 117 patients,49(41.88%)did not experience recurrence or death,while the remaining 68(58.12%)experienced recurrence or death(59 cases of recurrence and 9 deaths).There were significant differences in TNM staging and lymph node metastasis between the two groups(P<0.05).The slope of energy spectrum curve,iodine concentration(IC)in venous phase,and normalized iodine concentration(NIC)in venous phase were higher in the poor prognosis group than in the good prognosis group(P<0.05).However,there were no significant differences in IC in arterial phase,NIC in arterial phase,effective atomic number in arterial phase and effective atomic number in venous phase between the two groups(P>0.05).For predicting poor prognosis of colorectal cancer,the area under the curve(AUC)of NIC in venous phase was the largest,which was 0.974(95%CI:0.927~0.995).Its sensitivity and specificity were 85.29%and 97.96%(P<0.05).The AUC of slope of energy spectrum curve was the smallest,which was 0.608(95%CI:0.514~0.697).Its sensitivity and specificity were 25.00%and 95.92%(P<0.05).The AUC of combination of the four parameters was 0.912(95%CI:0.846~0.957).The sensitivity and specificity were 92.65%and 89.80%(P<0.05).Conclusion:There are differences in TNM staging and lymph node metastasis between colorectal cancer patients with different prognoses.Quantitative parameters of spectral CT have good predictive value for poor prognosis of colorectal cancer,and the predictive efficacy of NIC in venous phase is the best.Combined use of parameters can significantly improve the sensitivity.Quantitative parameters of spectral CT can be used as auxiliary indicators for predicting poor prognosis of colorectal cancer in clinical practice.
作者
汤晓宇
陈菁华
TANG Xiao-yu;CHEN Jing-hua(Imaging Department,Taicang Afiliated Hospital of Nanjing University of Traditional Chinese Medicine,Taicang Jiangsu 215400,China)
出处
《中国临床医学影像杂志》
北大核心
2025年第11期801-804,共4页
Journal of China Clinic Medical Imaging
基金
苏州市医学会"影像医星"科技项目(立项项目编号:2023YX-Q07)
苏州市医疗科学技术项目(项目编号:SKJYD2021011)。
