定量CT联合MRI扩散加权成像在预测肺癌表皮生长因子受体突变中的应用价值
Application value of quantitative CT combined with MR diffusion weighted imaging in predicting epidermal growth factor receptor mutations in lung cancer
张敏 1于楠 1王斌 2郭炎兵 1于勇 3段海峰 3党珊1
作者信息
- 1. 陕西中医药大学附属医院医学影像科 陕西 咸阳 712000
- 2. 陕西中医药大学 陕西 咸阳 712046
- 3. 陕西中医药大学附属医院医学影像科 陕西 咸阳 712000;陕西中医药大学 陕西 咸阳 712046
- 折叠
摘要
目的 探讨采用定量CT联合MRI扩散加权成像(MR-DWI)预测肺癌表皮生长因子受体(EGFR)基因突变状态,并评估二者的诊断效能.方法 选取 47 例经EGFR基因检测的肺腺癌患者,其中EGFR突变 19 例,未突变 28 例.全部患者治疗前均接受CT、MRI扫描,并取病理活检.将CAD定量分析结果及ADC值进行分析,并将有统计学意义的参数使用二元Logistic回归分析,用于筛选预测EGFR突变的影响因子.绘制ROC曲线,评估预测效能.结果 两组间性别、年龄差异无统计学意义(P>0.05),病灶体积差异有统计学意义(P=0.020).由 2 位放射科医师对ADC值测量的一致性较好(ICC=0.978).EGFR突变型组与野生型组两组间ADC值差异有统计学意义(P=0.045).肿瘤体积、ADC值均是预测肺腺癌EGFR基因突变状态的独立危险因素.联合ADC值与体积二者较单独ADC值、体积可提高预测EGFR突变状态的敏感度(84.2%vs 50.0%vs 64.3%)及AUC(0.805 vs 0.674 vs 0.701).结论 肿瘤体积、MR-DWI ADC值可用来无创的预测肺癌EGFR基因突变状态,联合二者可提高预测能力,为临床制定治疗策略提供影像学依据.
Abstract
Objective Quantitative CT and DWI were used to predict EGFR gene mutation status in lung adenocarcinoma,and to evaluate the diagnostic efficacy of the two methods.Methods Forty-seven patients with lung adenocarcinoma tested by EGFR gene were retrospectively collected,including 19 cases with EGFR mutation and 28 cases without mutation.All patients received CT and MR scans and biopsies before treatment.The quantitative analysis results of CT and ADC value were analyzed,and the parameters with statistical significance were analyzed by binary Logistic regression to screen the influencing factors for predicting EGFR mutation.ROC curve was drawn to evaluate the predictive performance.Results There was no significant dif-ference in gender and age between the two groups(P>0.05),but there was significant difference in tumor volume(P=0.020).There was good agreement between the two radiologists on ADC measurements(ICC=0.978).There was statistical difference in ADC values between EGFR mutation and wild group(P=0.045).Tumor volume and ADC value were independent risk factors for predicting EGFR gene mutation status in lung cancer.Tumor volume,ADC value and the combination of them had well sensitiv-ity and specificity in predicting EGFR mutation status,with AUC of 0.701,0.674 and 0.805,respectively.Conclusions Tu-mor volume and ADC value can be used to noninvasively predict EGFR gene mutation status in lung cancer,and the combination of the two can improve the predictive ability and provide imaging basis for clinical treatment strategy.
关键词
肺腺癌/表皮生长因子受体/体层摄影术,X线计算机/表观扩散系数Key words
Lung adenocarcinoma/Epidermal growth factor receptor/Tomography,X-ray computer/Apparent diffusion co-efficient引用本文复制引用
基金项目
陕西省重点研发计划项目(2021ZDLSF04-10)
出版年
2024
NETL
NSTL
万方数据