ISSN 1004-4140
CN 11-3017/P
窦沛沛, 赵恒亮, 曹爱红. 能谱CT联合肿瘤标志物预测肺腺癌Ki-67表达[J]. CT理论与应用研究, 2023, 32(6): 753-760. DOI: 10.15953/j.ctta.2022.172.
引用本文: 窦沛沛, 赵恒亮, 曹爱红. 能谱CT联合肿瘤标志物预测肺腺癌Ki-67表达[J]. CT理论与应用研究, 2023, 32(6): 753-760. DOI: 10.15953/j.ctta.2022.172.
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DOU P P, ZHAO H L, CAO A H. Spectral CT Combined with Tumor Markers to Predict Ki-67 Expression in Lung Adenocarcinoma[J]. CT Theory and Applications, 2023, 32(6): 753-760. DOI: 10.15953/j.ctta.2022.172. (in Chinese).
Citation: DOU P P, ZHAO H L, CAO A H. Spectral CT Combined with Tumor Markers to Predict Ki-67 Expression in Lung Adenocarcinoma[J]. CT Theory and Applications, 2023, 32(6): 753-760. DOI: 10.15953/j.ctta.2022.172. (in Chinese).
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能谱CT联合肿瘤标志物预测肺腺癌Ki-67表达

Spectral CT Combined with Tumor Markers to Predict Ki-67 Expression in Lung Adenocarcinoma

    摘要
  • 摘要: 目的：探讨能谱CT定量参数联合血清肿瘤标志物（CEA、CA-125）对肺腺癌Ki-67表达的预测价值。方法：回顾性分析2020年6月至2022年2月经病理证实为肺腺癌的64例患者临床病理及影像学资料，所有患者均行双期能谱CT检查，且疗前血清CEA和CA-125水平明确。根据术后病理结果分为Ki-67高表达组（＞30％）、Ki-67低表达组（≤30％）。经双能量后处理工作站测得能谱相关定量参数碘值（IC）、标准化碘比率（NIC）及能谱曲线斜率（λHU），根据病历资料获取疗前血清CEA和CA-125表达水平。采用t/Mann-Whitney U检验、\chi^2 检验比较两组间各参数的差异，采用ROC曲线评估参数的预测效能。结果：Ki-67低表达组静脉期IC、NIC和λHU值均高于高表达组，组间差异有统计学意义；Ki-67高表达组血清CEA及CA-125水平高于低表达组，组间差异有统计学意义；其他参数组间差别无统计学意义。ROC曲线分析显示多因素联合指标对Ki-67的预测效能明显高于各单因素指标，曲线下面积为0.754，敏感度为77.78％，特异度为72.97％。结论：静脉期能谱CT定量参数、血清CEA及CA-125水平对预测Ki-67表达有一定价值，能够为临床治疗方案的选择提供一定依据。

     

    Abstract: Purpose: To investigate the predictive value of energy spectrum CT quantitative parameters combined with serum tumor markers (CEA, CA-125) on Ki-67 expression in lung adenocarcinoma. Methods: The clinicopathological and imaging data of 64 patients with lung adenocarcinoma confirmed by pathology from June 2020 to February 2022 were retrospectively analyzed. All patients underwent dual-phase energy spectrum CT examination, and serum CEA and CA-125 levels before treatment were clear. Based on postoperative pathological results, patients were divided into two groups, the high expression group of Ki-67 (>30%) and the low expression group of Ki-67 (≤30%). The iodine value (IC), standardized iodine ratio (NIC), and the slope of the energy spectrum curve (λHU) were measured by a dual-energy post-processing workstation. The expression levels of SERUM CEA and CA-125 before treatment were obtained according to medical records. Statistical analysis of the data was performed with SPSS 22.0; t-test or Mann−Whitney U test and \chi^2 tests were used to compare the differences in parameters between the two groups, and the ROC (receiver operating characteristic curve, ROC) curve was used to evaluate the prediction efficiency of the parameters. Results: The IC, NIC, and λHU values in the low expression group were higher than those of the high expression group, and the differences were statistically significant. Serum CEA and CA-125 levels in the Ki-67 high expression group were higher than those of the low expression group, and the difference was statistically significant. There were no significant differences in other parameters between the two groups. ROC curve analysis showed that CEA had the best predictive efficiency for Ki-67, with an area under the curve of 0.697, sensitivity of 39.17%, and specificity of 100%. Conclusions: The quantitative parameters of energy spectrum CT in the venous phase, serum CEA, and CA12-5 levels have a certain value in predicting the expression of Ki-67, which can provide a basis for selecting a clinical treatment plan.

     

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