实体肺腺癌能谱CT定量参数与表皮生长因子受体、间变性淋巴瘤激酶突变状态的相关性
Correlation of EGFR and ALK Mutation Status in Solid Lung Adenocarcinoma Based on Quantitative Parameters of Spectral CT
魏正琦 1梁长华 1甄思雨 1谢北辰 1姚阳阳1
作者信息
- 1. 新乡医学院第一附属医院放射科,河南 新乡 453100
- 折叠
摘要
目的 分析能谱CT定量参数与实体肺腺癌表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)基因突变状态的相关性,以期通过能谱参数联合临床指标预测实体肺腺癌基因突变的表达.资料与方法 回顾性收集2020年5月—2022年5月新乡医学院第一附属医院行能谱CT平扫+增强扫描且经病理证实的 86 例肺腺癌患者的影像资料与临床资料,根据EGFR以及ALK突变状态分为突变组(43例)与野生组(43例).获取平扫、动脉期及静脉期40 keV、70 keV及100 keV单能量CT值、能谱曲线斜率,平扫有效原子序数,动、静脉期碘浓度、同层面动脉期碘浓度以及水浓度,计算标准化碘基值.将差异有统计学意义的参数构建预测模型,使用受试者工作特征曲线评价模型预测效能.结果 EGFR 突变组与野生组性别、吸烟状态差异有统计学意义(χ2=5.628,P=0.018;χ2=4.214,P=0.040);平扫有效原子序数和能谱曲线斜率、动脉期40 keV、70 keV及100 keV单能量 CT 值、静脉期 40 keV 单能量 CT 值、动静脉双期能谱曲线斜率及标准化碘基值在两组间差异均有统计学意义(t=2.067～4.394,P均<0.05);Logistic回归分析得出,静脉期标准化碘基值及能谱曲线斜率是EGFR基因突变状态的独立预测因素.ALK突变组与野生组中,平扫及动脉期能谱CT定量参数差异无统计学意义(P>0.05).静脉期水基值在两组间差异有统计学意义(t=2.058,P=0.043).结论 能谱CT定量特征与实体肺腺癌EGFR、ALK基因突变状态具有相关性,其中基于能谱定量特征与临床特征结合建立的Logistic回归模型在预测EGFR基因突变中有一定价值.
Abstract
Purpose To analyze the correlation between quantitative parameters of spectral CT and the mutation status of epidermal growth factor receptor(EGFR)and anaplastic lymphoma kinase(ALK)genes in solid lung adenocarcinoma,in order to predict the expression of gene mutation in solid lung adenocarcinoma by combining spectral parameters with clinical indicators.Materials and Methods The imaging and clinical data of 86 patients in the First Affiliated Hospital of Xinxiang Medical College pathologically confirmed with lung adenocarcinoma who underwent energy spectral CT plain and enhanced scans from May 2020 to May 2022 were retrospectively collected.According to the mutation status of EGFR and ALK genes,all patietns were divided into mutation group(43 cases)and wild group(43 cases).The single-energy CT values(including 40 keV,70 keV and 100 keV),slope of energy spectrum curve,effective atomic number during plain scan,iodine concentration in arterial and venous phases,water concentration and iodine concentration in arteries at the same level were obtained,and standardized iodine base value was also calculated.Statistically significant parameters were used to construct the prediction model,and the receiver operating characteristic curve was performed to evaluate the prediction efficiency of the model.Results There were statistically significant differences in gender and smoking status between the EGFR mutation group and the wild-type group(χ2=5.628,P=0.018;χ2=4.214,P=0.040).There were statistically significant differences in plain scan effective atomic number and energy spectrum slope,arterial phase 40 keV,70 keV and 100 keV single-energy CT values,40 keV single-energy CT values in the venous phase,the slope of the arteriovenous dual-phase energy spectrum and the standardized iodine base value between the two groups(t=2.067-4.394,all P<0.05).Logistic regression analysis showed that normalized iodine base value and energy spectrum slope in venous phase were the independent predictors of EGFR gene mutation status.There were no significant differences in quantitative parameters of plain scan and arterial phase energy spectrum CT between the ALK mutant group and the wild-type group(P>0.05).There was statistically significant difference in water base value of venous phase between the two groups(t=2.058,P=0.043).Conclusion The quantitative features of spectral CT may be correlated with the mutation status of EGFR and ALK genes in solid lung adenocarcinoma,and the Logistic regression model based on the combination of quantitative features of spectral CT and clinical features has certain value in predicting EGFR gene mutation.
关键词
肺腺癌/能谱分析/表皮生长因子受体/间变性淋巴瘤激酶Key words
Adenocarcinoma of lung/Spectrum analysis/Epidermal growth factor receptor/Anaplastic lymphoma kinase引用本文复制引用
出版年
2024
NETL
NSTL
万方数据