能谱CT定量参数预测结直肠癌Ki-67表达水平:一项前瞻性研究OA
A prospective study on predicting Ki-67 expression level in colorectal cancer using quantitative parameters of spectral CT
目的 探究能谱CT定量参数对结直肠癌Ki-67表达水平的预测价值.方法 前瞻性收集2023年1月～2025年7月于包头医学院第一附属医院术前行全腹部能谱CT增强扫描并经病理证实为结直肠腺癌的59例患者为研究对象,收集患者的影像资料及临床资料,根据Ki-67表达指数将患者分为高表达组(Ki-67≥70%,n=40)和低表达组(Ki-67<70%,n=19).使用AW4.7后处理工作站测量病灶在能谱CT 3期增强检查的CT40 keV值、CT70 keV值、CT100 keV值、碘浓度(IC)及有效原子序数(Zeff),并计算标准化碘浓度(NIC)、能谱曲线斜率(λHU),比较各组参数之间的差异,绘制ROC曲线并分析这些参数独立及联合预测Ki-67表达水平的效能.结果 Ki-67高表达组3期IC、λHU、Zeff、CT40 keV、CT70 keV均高于低表达组,Ki-67高表达组动脉期CT100 keV、延迟期NIC高于低表达组,差异有统计学意义(P<0.05).ROC曲线表明,延迟期IC、NIC、Zeff对Ki-67表达水平预测效能较高(AUC=0.737、0.730、0.718,敏感度77.5%、50.0%、77.5%,特异度73.7%、89.5%、68.4%).结论 能谱CT定量参数中延迟期IC、NIC、Zeff对于结直肠癌Ki-67表达水平具有一定的预测价值,三者联合可提高前瞻性预测Ki-67表达水平的效能.
Objective To investigate the predictive value of quantitative spectral CT parameters for Ki-67 expression levels in colorectal cancer.Methods A prospective study was conducted on 59 patients who underwent pre-operative whole-abdominal spectral CT enhanced scanning at the First Affiliated Hospital of Baotou Medical College from January 2023 to July 2025 and were pathologically confirmed to have colorectal adenocarcinoma.Imaging and clinical data were collected.Patients were divided into high-expression group(Ki-67≥70%,n=40)and low-expression group(Ki-67<70%,n=19)based on the Ki-67 expression index.The CT40 keV,CT70 keV,CT100 keV values,iodine concentration(IC),and effective atomic number(Zeff)of the lesions were measured using the AW4.7 post-processing workstation during the three-phase contrast-enhanced spectral CT examination.Normalized iodine concentration(NIC)and spectral curve slope(λHU)were calculated.Differences in parameters between the two groups were compared.ROC curves were plotted to evaluate the independent and combined predictive performance of these parameters for Ki-67 expression levels.Results The three-phase IC,λHU,Zeff,CT40 keV,and CT70 keV values in the Ki-67 high-expression group were significantly higher than those in the low-expression group.The arterial phase CT100 keV and delayed-phase NIC were also significantly higher in the high-expression group compared with the low-expression group(P<0.05).ROC curve analysis showed that delayed-phase IC,NIC,and Zeff had relatively high predictive efficacy for Ki-67 expression levels(AUC=0.737,0.730,and 0.718;sensitivity=77.5%,50.0%,and 77.5%;specificity=73.7%,89.5%,and 68.4%).Conclusion Among the quantitative spectral CT parameters,delayed-phase IC,NIC,and Zeff have certain predictive value for Ki-67 expression levels in colorectal cancer,and the combination of these three parameters can improve the prospective predictive efficacy for Ki-67 expression levels.
边颖;陈强;张爱民;罗成茂;张宇;原小军
包头医学院研究生院,内蒙古 包头 014040||包头医学院第一附属医院医学影像科,内蒙古 包头 014010||包头医学院医学影像研究所,内蒙古 包头 014040包头医学院第一附属医院医学影像科,内蒙古 包头 014010||包头医学院医学影像研究所,内蒙古 包头 014040包头医学院第一附属医院消化内科,内蒙古 包头 014010包头医学院第一附属医院医学影像科,内蒙古 包头 014010||包头医学院医学影像研究所,内蒙古 包头 014040包头医学院第一附属医院医学影像科,内蒙古 包头 014010||包头医学院医学影像研究所,内蒙古 包头 014040包头医学院第一附属医院医学影像科,内蒙古 包头 014010||包头医学院医学影像研究所,内蒙古 包头 014040
能谱CT结直肠癌Ki-67术前预测
spectral CTcolorectal cancerKi-67preoperative prediction
《分子影像学杂志》 2026 (5)
571-578,8
内蒙古自治区自然科学基金项目(2021MS08003)
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