肺癌Ki-67表达与CT影像征象及定量参数之间的相关性

目的  探讨肺癌CT征象及定量参数与Ki-67抗原表达水平的相关性。方法  回顾性分析我院93例行CT扫描且经病理证实的肺癌患者的临床及影像资料，采用能谱CT进行常规平扫，肿瘤标本行免疫组化染色，检测Ki-67抗原表达水平，观察肺癌CT影像征象。采用计算机辅助诊断软件对原发肺癌进行勾勒、分割，记算CT定量参数。分析Ki-67表达水平与CT征象及定量参数之间的相关性，并绘制ROC曲线分析CT影像征象及定量参数对Ki-67表达水平的预测效能。结果  Ki-67表达水平与性别及病理类型相关（P < 0.05），男性、肺鳞癌Ki-67表达指数更高；Ki-67表达水平与CT各影像征象无相关性（P > 0.05）；肿瘤血管体积在Ki-67不同表达组之间的差异有统计学意义（P < 0.05）；Spearman非参数相关性分析显示血管体积与Ki-67表达水平呈正相关关系（r=0.224，P=0.03），ROC曲线下面积在低中水平、低高水平、中高水平间分别为0.726、0.759、0.569。结论  CT定量参数（血管体积）可用于评估肺癌Ki-67表达水平，且与Ki-67表达水平呈正相关关系，在一定程度上可以协助临床评估肺癌患者肿瘤细胞增殖活性。

Correlation between the expression of Ki-67 in lung cancer and CT signs and quantitative parameters

Objective To explore the correlation between CT signs and quantitative parameters of lung cancer and the expression level of Ki-67 antigen. Methods Clinical and imaging data of 93 patients with lung cancer confirmed by pathology who underwent CT scan in our hospital were retrospectively analyzed. Routine CT scan was performed using spectral CT, and tumor specimens were subjected to immunohistochemical staining to detect the expression level of Ki-67 antigen. CT signs of lung cancer were observed. Computer-aided diagnosis software was used to delineate and segment the primary lung cancer, and CT quantitative parameters were calculated. The correlation between Ki-67 expression level and CT signs and quantitative parameters was analyzed. ROC curve was drawn to analyze the predictive efficacy of CT signs and quantitative parameters on Ki-67 expression level. Results The expression level of Ki-67 was related to gender and pathological type(P < 0.05), with higher expression index in males and lung squamous cell carcinoma. There was no correlation between the expression level of Ki-67 and various CT signs(P > 0.05). The difference in tumor vascular volume between different Ki-67 expression groups was statistically significant (P < 0.05). Spearman non-parametric correlation analysis showed a positive correlation between vascular volume and Ki-67 expression level (r=0.224, P=0.03). The area under curves were 0.726, 0.759, and 0.569 in the low-medium level, low-high level, and medium-high level, respectively. Conclusion CT quantitative parameters (vascular volume) can be used to evaluate the expression level of Ki-67 in lung cancer. They are positively correlated with Ki-67 expression level. They can assist in the clinical evaluation of tumor cell proliferation activity in patients with lung cancer to a certain extent.