| 双源CT多定量参数对胃癌的诊断价值及与HER2的相关性 |
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| 引用本文： | 安岁萌,魏 升,袁漳辰,黄明刚,张 艳.双源CT多定量参数对胃癌的诊断价值及与HER2的相关性[J].现代肿瘤医学,2020,0(15):2697-2701. |
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| 作者姓名： | 安岁萌 魏 升 袁漳辰 黄明刚 张 艳 |
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| 作者单位： | 1.渭南市中心医院，陕西 渭南 714000;2.西安医学院，陕西 西安 710000;3.湘雅医学院，湖南 长沙 410013;4.陕西省人民医院CT室，陕西 西安 710068 |
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| 基金项目： | 陕西省自然科学基础研究计划项目（编号:2014JM2-8201） |
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| 摘 要： | 目的:探讨门脉期双源CT多个定量参数与胃腺癌病理分化程度及HER2的相关性。方法: 回顾性分析2018年7月至2019年4月间于陕西省人民医院行双源CT双能量扫描的48例经胃镜活检(21例)或手术病理证实（27例）的胃腺癌及30例正常胃的影像学资料，其中27例HER2指标明确，通过西门子第二代双源CT扫描获得静脉期双能量图像，利用syngo.via软件获得曲线斜率、门脉期碘浓度、标准化碘浓度；将患者分为胃腺癌与正常胃壁组，高、中、低分化胃腺癌组，HER2阳性组（+，++，+++）与HER2阴性组（-）。统计学方法采用Kappa一致性检验、ROC曲线法、两独立样本t检验及方差分析。结果:活检与术后病理结果具有较强的一致性（Kappa系数为0.701），两者无明显差异；胃腺癌与正常胃壁两组间能谱曲线斜率（1.35±0.24、2.19±0.71）及标准化碘浓度（0.31±0.079、0.54±0.157）均具有统计学意义（P<0.05），曲线下面积分别为0.992、0.919；低分化、中分化及高分化胃腺癌能谱曲线斜率值（3.07±0.67，2.63±0.57，2.01±0.39）组间及组内差异均具有统计学意义（P<0.05），低分化、中分化及高分化胃腺癌门脉期标准化碘浓度(0.60±0.167，0.52±0.089，0.36±0.039)组间差异具有统计学意义（P<0.05），中分化组与低分化组差异无统计学意义（P>0.05），高分化组与中、低分化组均具有统计学差异（P<0.05）。HER2阳性组与阴性组的能谱曲线斜率及标准化碘浓度值无统计学差异（P>0.05）。结论:能谱曲线斜率及门脉期标准化碘浓度值有助于对胃腺癌进行诊断并推测病理分化程度；双源CT定量参数与免疫组化指标HER2无相关性。
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| 关 键 词： | 胃腺癌 双源CT 能谱曲线斜率 标准化碘浓度 HER2 |
Diagnostic value of dual-source CT for gastric adenocarcinoma and its correlation with HER2 |
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| An Suimeng,Wei Sheng,Yuan Zhangchen,Huang Minggang,Zhang Yan.Diagnostic value of dual-source CT for gastric adenocarcinoma and its correlation with HER2[J].Journal of Modern Oncology,2020,0(15):2697-2701. |
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| Authors: | An Suimeng Wei Sheng Yuan Zhangchen Huang Minggang Zhang Yan |
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| Affiliation: | 1.Weinan Central Hospital,Shaanxi Weinan 714000,China;2.Xi'an Medical College，Shaanxi Xi'an 710000，China；3.Xiangya Medical College，Hunan Changsha 410013，China;4.CT Department of Shaanxi Provincial People's Hospital，Shaanxi Xi'an 710068，China. |
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| Abstract: | Objective:To explore the relationship between multiple quantitative parameters of portal phase dual-source CT and pathological differentiation degree and HER2 of gastric adenocarcinoma.Methods:48 cases of gastric adenocarcinoma confirmed by gastroscopy biospy （21 cases）or surgical pathology（27 cases） and 30 cases of normal stomach of the People's Hospital of Shaanxi Province from July 2018 to April 2019 were retrospectively analyzed.Among them，27 patients had clear immunohistochemical HER2 index.Portal-phase's dual-energy imaging was obtained by Siemens dual-source CT scan，and the image was transferred to Dual Energy software to obtain the Energy spectral curve and portal-phase's iodine concentration，and the slope and standardized iodine concentration were calculated.According to the pathological results，patients were divided into gastric adenocarcinoma and normal groups.Patients were divided into lower，moderate and high differentiation groups.Patients were divided into HER2 positive group(+，++，+++）and HER2 negative(-）group.Statistical analysis was performed using Kappa conformance test，ROC curve method，two independent samples t test and analysis of variance.Results:There was a strong consistency between biopsy and postoperative pathological results(Kappa coefficient was 0.701)，and it was no significant difference.The spectral curve slopes （1.35±0.24，2.19±0.71）and normalized iodine concentration (0.31±0.079，0.54±0.157） of normal gastric wall and gastric adenocarcinoma were statistically significant(P<0.05).The area under the curve was 0.992，0.919 respectively.The spectrum curve slope of poorly differentiated，moderately differentiated and highly differentiated gastric adenocarcinoma(3.07±0.67，2.63±0.57，2.01±0.39）was statistically significant(P<0.05).The iodine concentration in the portal phase of poorly differentiated，moderately differentiated and highly differentiated gastric adenocarcinoma(0.60±0.167，0.52±0.089，0.36±0.039）was statistically significant(P<0.05).There were no significant differences between the moderately differentiated group and the poorly differentiated group(P>0.05).However,the differences between the highly differentiated group and the moderately differentiated group or the poorly differentiated group(P<0.05）were significant.The differences in slope value and normalized iodine concentration between HER2 positive group and negative group(P>0.05）were unconspicuous.Conclusion:The slope of the spectral curve and the normalized iodine concentration value of the portal phase are helpful for the diagnosis of gastric adenocarcinoma and the conjecture of the pathological differentiation degree.The quantitative parameters of dual source CT have no correlation with the immunohistochemical index HER2. |
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| Keywords: | gastric adenocarcinoma dual source CT energy spectral curve slope normalized iodine concentration HER2 |
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