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能谱CT联合肿瘤标志物预测肺腺癌Ki-67表达

窦沛沛 赵恒亮 曹爱红

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(0): 1-8. 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(0): 1-8. DOI: 10.15953/j.ctta.2022.172
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(0): 1-8. 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(0): 1-8. DOI: 10.15953/j.ctta.2022.172. (in Chinese)

能谱CT联合肿瘤标志物预测肺腺癌Ki-67表达

doi: 10.15953/j.ctta.2022.172
基金项目: 徐州市卫生健康委员会青年医学科技创新项目(XWKYHT20210563)。
详细信息
    作者简介:

    窦沛沛:女,徐州医科大学第二附属医院影像科医师,徐州医科大学影像医学与核医学专业在读博士,主要从事CT成像及诊断等方面的研究,E-mail:1062920760@qq.com

    曹爱红:男,博士,徐州医科大学第二附属医院影像科主任医师、硕士研究生导师,主要从事CT/MR、X线等医学影像诊断,E-mail:caooh@163.com

    通讯作者:

    曹爱红*,

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

  • 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、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、CA-125表达水平。采用t/Mann-Whitney U检验、χ2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、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。

     

  • 图  1  能谱CT虚拟成像

    Figure  1.  Spectral CT virtual imaging

    图  2  病例CT图像特征示意图,患者男,62岁,右肺下叶肺腺癌

    Figure  2.  Schematic diagram of CT images of one case. The patient is a 62-year-old male with adenocarcinoma of the lower lobe of the right lung

    图  3  各参数预测Ki-67的ROC曲线分析

    Figure  3.  ROC curve analysis of Ki-67 prediction parameters

    图  4  多因素联合指标预测Ki-67的ROC曲线分析

    Figure  4.  ROC curve analysis of multi-factor combined index prediction Ki-67

    表  1  Ki-67高低表达组间临床及影像学特征比较(n=64)

    Table  1.   Comparison of clinical and imaging characteristics between the high and low Ki-67 expression groups(n=64)

    项目参数例数(百分比)低表达组高表达组P
    性别       男性31(48.4)14170.994
    女性33(51.6)1815
    年龄(平均数,岁)≤6231(48.4)18130.604
    >6233(51.6)1419
    结节或肿块/cm   结节(≤3)30(46.9)17130.113
    肿块(>3)34(53.1)1519
    长径(中位数,mm) ≤3234(53.1)22120.735
    >3230(46.9)1020
    短径(中位数,mm)≤2332(50.0)20120.351
    >2332(50.0)1220
    下载: 导出CSV

    表  2  高、低Ki-67表达组间能谱定量参数、血清肿瘤标志物水平比较(n=64)

    Table  2.   Comparison of quantitative parameters of the energy spectrum and serum tumor markers between the high and low Ki-67 expression groups(n=64)

    项目参数低表达组($ \overline X $±S)高表达组($ \overline X $±S)P
    动脉期    IC1.182±0.2530.870±0.0900.984
    NIC0.125±0.0240.998±0.0120.727
    λHU1.788±0.3051.240±0.0970.702
    静脉期    IC1.782±0.2031.122±0.2130.020
    NIC0.405±0.0410.227±0.0250.026
    λHU2.399±0.2951.458±0.1070.013
    血清肿瘤标志物CEA12.081±3.37542.468±11.3220.032
    CA-1254.337±0.8849.106±1.7030.045
     注:低表达组:Ki-67<30%;高表达组:Ki-67≥30%;IC:碘值;NIC:标准化碘比率;λHU:40 keV-100 keV之间的能谱衰减
       曲线斜率;CEA:癌胚抗原;CA-125:糖类抗原;粗体表示高低Ki-67组间存在显著性差异(P<0.05)。
    下载: 导出CSV

    表  3  能谱参数及血清肿瘤标志物水平预测Ki-67的效能

    Table  3.   Efficacy of energy spectrum parameters and serum tumor marker levels in predicting Ki-67

    参数AUC截断值敏感性/%特异性/%P
    CEA0.69744.0739.13100.000.019
    CA-1250.6885.2652.1788.240.026
    *IC0.6691.0048.3981.820.014
    *NIC0.66225.354.8478.790.019
    *λHU0.6801.1941.9493.940.008
     注:CEA:癌胚抗原;CA-125:糖类抗原;*:静脉期;IC:碘值;NIC:标准化碘比率;λHU:40~100 keV之间的能谱衰减曲
       线斜率。
    下载: 导出CSV

    表  4  多因素联合指标预测Ki-67的效能

    Table  4.   Prediction of Ki-67 performance by multiple factors combined with indicators

    参数AUC敏感性/%特异性/%P
    联合指标0.75477.7872.97<0.01
     注:联合指标:各项单因素指标(CEA、CA-125及静脉期IC、NIC、λHU)逻辑回归后所生成的多因素联合指标。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-08-25
  • 修回日期:  2023-01-15
  • 录用日期:  2023-01-16
  • 网络出版日期:  2023-02-27

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