摘要
目的运用能谱计算机断层扫描(computed tomography,C T)分析不同分化程度食管鳞癌的参数特征,并探讨其临床应用价值.方法收集2015-06/2017-05期间,经病理证实的71例食管鳞癌患者的临床资料进行回顾性分析,并根据分化程度的不同,分为低分化食管鳞癌(32例)和中高分化食管鳞癌(39例).所有患者均于治疗前行能谱CT检查,测量并记录各病灶的40 keV单能量CT值、能谱曲线斜率、碘浓度、水浓度及标准化碘浓度.运用ROC曲线对差异显著的参数进行诊断效能分析.结果低分化食管鳞癌的碘浓度、标准化碘浓度及能谱曲线斜率明显高于中高分化食管鳞癌,差异均有统计学意义(均P<0.05);低分化食管鳞癌的40 keV单能量CT值明显高于中高分化食管鳞癌,差异均有统计学意义(均P<0.05);以标准化碘浓度判断食管鳞癌分化程度的诊断效能最高,曲线下面积=0.835,临界值=0.365时,敏感度=73.7%,特异度=93.9%.结论能谱CT为食管鳞癌分化程度的术前判定提供一种全新方法 ,能定量分析食管鳞癌在不同分化程度下的能谱参数特征,具有一定临床应用价值.
AIM To analyze the parameter characteristics of energy spectral computed tomography（CT） imaging of esophageal squamous cell carcinoma with different levels of differentiation, and to assess its clinical value. METHODS The clinical data of 71 patients with esophageal squamous cell carcinoma diagnosed pathologically from June 2015 to May 2017 were retrospectively analyzed. According to tumor differentiation, the patients were divided into a poorly differentiated group（32 cases） and a moderately/well differentiated group（39 cases）. All patients were examined by energy spectral CT before treatment. The 40 keV single energy CT value, slope of spectral curve, iodine concentration, water concentration, and standardized iodine concentration were recorded. The diagnostic efficiency of the parameters with significant difference was assessed by ROC curve analysis. RESULTS The iodine concentration,standard izediodine concentration, and slope of spectral curve of poorly differentiated esophageal squamous cell carcinoma were significantly higher than those of moderately/well differentiated esophageal squamous cell carcinoma（P 0.05）. The 40 keV single energy CT value of poorly differentiated esophageal squamous cell carcinoma was also significantly higher than that of moderately/well differentiated esophageal squamous cell carcinoma（P 0.05）. The diagnostic efficiency of standardized iodine concentration in esophageal squamous cell carcinoma was the highest; the area under the ROC curve was 0.835, with a sensitivity of 73.7% and a specificity of 93.9% at a cutoff value of 0.365. CONCLUSION Energy spectral CT allows for preoperative evaluation of differentiation of esophageal squamous cell carcinoma, and it can quantitatively analyze the spectral parameters of esophageal squamous cell carcinoma with different levels of differentiation.
出处
《世界华人消化杂志》
CAS
2017年第33期2967-2972,共6页
World Chinese Journal of Digestology
关键词
食管肿瘤
鳞癌
体层摄影术
能谱CT
细胞分化
Esophageal cancer
Squamous cell carcinoma
Computed tomography
Energy spectral computed tomography
Cell differentiation
