摘要
目的探讨能谱CT参数术前鉴别胃癌T3期和T4a期的价值。方法回顾性分系2015年7月至2018年9月郑州大学第一附属医院经手术病理确诊为胃腺癌并行能谱CT双期增强扫描的52例患者。其中胃癌T3期23例,T4a期29例。比较T3期与T4a期患者一般临床资料、胃癌周围脂肪以及胃癌原发灶动、静脉期碘浓度值(IC)、标准化碘浓度值(nIC)。采用Logistic回归分析法分析T4a期胃癌独立危险因素;绘制能谱CT参数诊断T4a期胃癌的受试者操作特征(ROC)曲线。结果 T3期与T4a期胃癌患者的胃癌原发灶分化程度、Borrmann分型差异均有统计学意义(P均<0.05)。T4a期胃癌患者胃癌周围脂肪间隙动、静脉期IC值、nIC值均高于T3期胃癌患者,且差异均有统计学意义(P均<0.05)。Logistic回归分析结果显示,胃癌周围脂肪间隙动、静脉期IC值是T4a期胃癌的独立危险指标(P<0.05)。胃癌周围脂肪间隙动、静脉期IC值、nIC值的ROC曲线下面积(AUC)分别为0.888、0.850、0.853、0.844,胃癌周围脂肪间隙动脉期IC值=-10.8为阈值诊断T4a期胃癌的效能最佳。结论胃癌周围脂肪间隙动、静脉期IC值可鉴别T3期和T4a期胃癌。腹部能谱CT可以提高胃癌术前诊断T分期准确率,为术前治疗方案的选择提供更多依据。
Objective To investigate the value of energy spectrum CT parameters in preoperative differentiation of stage T3 and T4 a gastric cancer.Methods A total of 52 patients with gastric adenocarcinoma diagnosed by surgical pathology in First Affiliated Hospital of Zhengzhou University from July 2015 to September 2018 were retrospectively analyzed.Among them,23 cases were stage T3 and 29 cases were stage T4 a.The general clinical data,perigastric fat,iodine concentration(IC) value and normalized iodine concentration(nIC) value of patients at T3 and T4 a stage were compared.The logistic regression analysis was used to analyzed the independent risk factors of T4 a gastric cancer.The receiver operating characteristic(ROC)curve was drawn to evaluate the discrimination efficiency of energy spectrum CT for T4 a gastric cancer.Results There were significant differences in primary differentiation degree and Borrmann classification between T3 and T4 a gastric cancer patients(both P<0.05).The IC value and nIC value of perigastric fat space in arterial and venous phases of T4 a gastric cancer patients were higher than those of T3 gastric cancer patients(all P<0.05).Logistic regression analysis showed that IC values in arterial and venous phases were independent risk indexes for T4 a gastric cancer(P<0.05).The area under ROC curve(AUC) of IC and nIC value of perigastric fat space in arterial and venous phases were 0.888,0.850,0.853 and 0.844,respectively,and the critical value of IC=-10.8 in arterial phase was the best for the diagnosis of T4 a stage gastric cancer.Conclusions The IC value of perigastric fat space in arterial and venous phases can be used to differentiate T3 and T4 a gastric cancer.Abdominal energy spectrum CT can improve the accuracy of preoperative diagnosis of T staging of gastric cancer and provide more basis for the selection of preoperative treatment.
作者
黄文鹏
李莉明
胡志伟
刘晨晨
邢静静
高剑波
Huang Wenpeng;Li Liming;Hu Zhiwei;Liu Chenchen;Xing Jingjing;Gao Jianbo(Department of Radiology,First Affiliated Hospital of Zhengzhou University,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor,Zhengzhou 450052,China)
出处
《中华消化病与影像杂志（电子版）》
2021年第6期257-262,共6页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
基金
国家自然科学基金(81271573,81971615)。
关键词
胃癌
肿瘤分期
能谱CT参数
Gastric cancer
Neoplasm staging
Energy spectrum CT parameters
