ISSN 1004-4140
CN 11-3017/P

非小细胞肺癌DLSCT双期定量参数与Ki-67表达水平的相关性研究

Correlation between Dual-Phase Quantitative Parameters from Dual-Layer Spectral Detector Computed Tomography and Ki-67 Expression in Non-Small Cell Lung Cancer

  • 摘要: 目的:研究双层探测器光谱CT(DLSCT)双期定量参数对非小细胞肺癌Ki-67表达的预测价值。方法:回顾性分析我院自2022年8月至2024年12月进行DLSCT双期增强扫描且经病理证实的非小细胞肺癌患者77例,按免疫组化结果分为低表达组(Ki-67≤30%)、高表达组(Ki-67>30%)。使用Spectral CT viewer软件测量、计算、分析两组病例动脉期和静脉期的双层光谱CT定量参数,包括碘密度(IC)、标准化碘密度(NIC)、有效原子序数(Zeff)、能谱曲线斜率(K40-100 keV,简称K)、MonoE(单能量光谱结果)间隔10 keV的CT40 keV-CT100 keV。统计学方法:采用独立样本t检验方法比较组间差异;用Spearman相关分析评价DLSCT双期定量参数和Ki-67表达水平间的相关性;绘制受试者工作曲线(ROC),获得曲线下面积(AUC),约登指数、敏感度、特异度衡量DLSCT各定量参数评估Ki-67表达水平的效能。结果:静脉期低表达组IC、NIC、Zeff、K40-100 keV、CT40 keV-CT70 keV(间隔10 keV)均高于高表达组,动脉期低表达组K40-100 keV、CT40 keV高于高表达组,差异均具有统计学意义。静脉期IC、NIC、Zeff、K40-100 keV、CT40 keV-CT60 keV(间隔10 keV)、动脉期K40-100 keV、CT40 keV与Ki-67表达水平呈负相关。绘制ROC,静脉期K40-100 keV评估非小细胞肺癌Ki-67表达水平最佳。结论:DLSCT双期定量参数是预测非小细胞肺癌 Ki-67 表达水平的有效工具,研究证据表明静脉期能谱曲线斜率 (K) 是其中最具预测价值的指标。

     

    Abstract: Objective: We investigated the predictive value of dual-phase quantitative parameters of dual-layer spectral detector computed tomography (DLSCT) combined with Ki-67 expression in non-small-cell lung cancer (NSCLC). Methods: Seventy-seven patients with pathologically confirmed non-small cell lung cancer who underwent dual-phase enhanced scanning at our hospital between August 2022 and December 2024 were retrospectively analyzed. According to immunohistochemical results, they were divided into low (Ki-67≤30%) and high (Ki-67>30%) Ki-67 expression groups. Spectral CT viewer software was used to measure, calculate, and analyze the quantitative parameters obtained with dual-layer spectral CT in the arterial and venous phases in both groups, including iodine density (IC), standardized iodine density (NIC), effective atomic number (Zeff), and energy spectrum curve slope (K, P < 0.05) (referred to as K and MonoE monochromatic energy spectroscopy) results, and CT40 keV-CT100 keV at 10 keV intervals. An independent samples t-test was used to compare differences between groups. Spearman’s correlation analysis was used to evaluate the correlation between the quantitative parameters of DLSCT and Ki-67 expression. A receiver-operating characteristic (ROC) curve was constructed to obtain the area under the curve (AUC). Youden index, sensitivity, and specificity were used to measure the efficacy of each quantitative parameter of DLSCT in predicting Ki-67 expression. Results: IC, NIC, Zeff, K40-100 keV, CT40 keV-CT70 keV (interval 10 keV) were higher in the low expression group than in the high expression group in venous phase, and K40-100 keV and CT40 keV were higher in the low expression group than in the high expression group in arterial phase. The differences were statistically significant (P<0.05). IC, NIC, Zeff, K40-100 keV, CT40 keV-CT60 keV (interval 10 keV) in venous phase, and K40-100 keV, CT40 keV in arterial phase correlated negatively with Ki-67 expression level (|r| < 0.40,P < 0.05). The ROC curve showed that K40-100 keV in venous phase was the best parameter for predicting Ki-67 expression in NSCLC (AUC=0.750). Conclusion: Dual-phase quantitative parameters of DLSCT are effective tools for predicting Ki-67 expression in non-small cell lung cancer, and research evidence shows that the slope (K) of the spectral curve in the venous phase is the most valuable index.

     

/

返回文章
返回