胃癌多层螺旋CT灌注成像及灌注参数与肿瘤因子的关联研究

目的研究多层螺旋CT灌注成像(MSCTPI)参数对胃癌的诊断价值,以及与肿瘤标志物之间的关联性。方法比较胃癌组与正常组的灌注参数,包括血流量(BF)、血容量(BV)、平均通过时间(MTF)、表面通透性(PS);采用Pearson相关分析方法分析灌注参数值与肿瘤标志物的关系,曲线(ROC)评估BV、BF、MTF、PS对胃癌的诊断效度。结果胃癌PS值明显高于对照组(P0.05);2组间BF差异有统计学意义(P0.05),而BV、MTT差异无统计学意义。Pearson相关分析显示PS与AFP、CEA、CA199、CA72-4均有显著相关性(r=0.58,0.40,0.38,0.77),BV、BF、MTT与CEA、AFP、CA199、CA72-4之间无明显相关性。应用ROC曲线分析BV、BF、MTT、PS对胃癌的诊断鉴别能力,其曲线下面积分别为0.62,0.64,0.50,0.83。当以PS18.85 mL/(min·100 g),作为强烈提示胃癌组织的可能性时,其敏感度和特异度分别为0.87和0.32。结论 MSCT灌注成像反映了胃肿瘤组织供血的情况,PS评估胃癌的效度最高,PS=17.98 mL/(min·100 mg)可作为判断正常胃壁与胃癌的阈值。部分灌注参数与肿瘤标志物间有相关性。

Study on association of multislice CT perfusion imaging and perfusion parameters of gastric cancer with tumor factors

Objective It is to investigate the value of the Mnhislice CT Perfusion imaging （MSCTPI） parameter in the diagnosis of gastric cancer, and the correlation with tumor markers. Methods perfusion parameters included the Blood flow （BF） , Blood volume （ BV ） , Mean through time （MTF） , surface permeability （PS） of gastric cancer group and normal group of were recorded ; the relationship of MSCTPI parameter with the tumor markers were analyzed by Pearson correlation analysis, the diagnosis validity of of BV, BF, MTF, PS on gastric cancer were evaluated by curve （ ROC）. Results PS value of Gastric cancer was significantly higher than that of control group （P 〈 0.05） , there was significant difference in BF between the two groups （P 〈 0 05） , while was no significant difference in BV and MTT. Pearson correlation analysis showed that there were significant correlation between PS value with AFP, CEA, CA199 and CA72 -4 respectively （r =0.58, 0.40, 0.38, 0.77）, but was no significant correlation between BV, BF, MTT with CEA, AFP, CA199, CA72 -4. ROC curve analysis application BV, BF, MTT, PS identification ability to the diagnosis of gastric cancer, the area under curve was 0.62, 0.64, 0.50 and 0. 83 respectively. When PS 〉 18.85 mL/（ 100g ·in） , as strongly suggest the possibility of gastric cancer tissue, its sensitivity and specific degree were 0.88 and 0 67 respectively. Conclusion MSCTPI can reflect gastric tumor tissue blood supply situation, the evaluated validity of PS on gastric cancer is the highest, PS = 18.85 mL/ （min·00 mg） can be used as judgment threshold of normal stomach and gastric cancer. Some have correlation between perfusion parameters and tumor markers.