文章摘要
王智涛,邹 玺,秦 斌,陈 虎,孙 鑫.增强CT图像纹理参数联合血清CEA、CA724在食管癌术后复发转移中的临床应用价值[J].,2023,(5):974-978
增强CT图像纹理参数联合血清CEA、CA724在食管癌术后复发转移中的临床应用价值
Clinical Application Value of Enhanced CT Image Texture Parameters Combined with Serum CEA and CA724 in the Recurrence and Metastasis of Esophageal Cancer after Operation
投稿时间:2022-06-18  修订日期:2022-07-14
DOI:10.13241/j.cnki.pmb.2023.05.035
中文关键词: 食管癌  增强CT  纹理分析  癌胚抗原  糖类抗原724  复发  转移
英文关键词: Esophageal carcinoma  Enhanced CT  Texture analysis  Carcinoembryonic antigen  Carbohydrate antigen 724  Recurrence  Metastasis
基金项目:江苏省重点研发计划-临床前沿技术项目(BE2019771)
作者单位E-mail
王智涛 江苏省中医院放射科 江苏 南京 210004 jsszyywzt@163.com 
邹 玺 江苏省中医院肿瘤科 江苏 南京 210004  
秦 斌 江苏省中医院放射科 江苏 南京 210004  
陈 虎 江苏省中医院放射科 江苏 南京 210004  
孙 鑫 江苏省中医院放射科 江苏 南京 210004  
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中文摘要:
      摘要 目的:研究增强计算机断层扫描(CT)图像纹理参数联合血清癌胚抗原(CEA)、糖类抗原724(CA724)在食管癌术后复发转移中的临床应用价值。方法:选取2019年6月-2021年7月于我院行手术治疗的86例食管癌患者,术前检测其血清CEA、CA724水平,并行增强CT扫描,将其动、静脉期图像数据行纹理分析,记录均值、中位数、标准差、不均匀度、偏度、峰度、熵值等参数。术后对86例食管癌患者进行12个月随访,根据其是否发生复发转移分为复发转移组(32例)与无复发转移组(54例),比较两组增强CT图像纹理参数及血清CEA、CA724水平差异;采用受试者工作特征(ROC)曲线分析增强CT图像纹理参数联合血清CEA、CA724对食管癌患者术后复发转移的预测价值。结果:复发转移组动脉期熵值高于无复发转移组(P<0.05);复发转移组静脉期不均匀度、熵值均高于无复发转移组(P<0.05)。复发转移组血清CEA、CA724水平高于无复发转移组(P<0.05)。ROC曲线显示,血清CEA、CA724联合动脉期熵值及静脉期不均匀度、熵值的曲线下面积(AUC)、敏感度、特异度均较各指标单独应用有明显提升,联合应用的预测效能更高。结论:血清CEA、CA724水平和动脉期熵值及静脉期不均匀度、熵值升高与食管癌患者术后发生复发转移有关,动脉期熵值及静脉期不均匀度、熵值联合血清CEA、CA724在预测食管癌患者术后发生复发转移中的应用价值较高。
英文摘要:
      ABSTRACT Objective: To study the clinical application value of enhanced computed tomography (CT) image texture parameters combined with serum carcinoembryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in the recurrence and metastasis of esophageal cancer after operation. Methods: 86 patients with esophageal cancer who underwent operation treatment in our hospital from June 2019 to July 2021 were selected. The serum CEA and CA724 levels were detected before operation, and enhanced CT scanning was performed, the image data of the arteriovenous phase were analyzed by texture, and the mean value, median, standard deviation, unevenness, skewness, kurtosis, entropy and other parameters were recorded. The patients with esophageal cancer were followed up for 12 months after operation. According to whether they had recurrence and metastasis, they were divided into recurrence and metastasis group(n=32) and non-recurrence and metastasis group(n=54). The differences of texture parameters of enhanced CT images and serum CEA and CA724 levels in the two groups were compared. Receiver Operating characteristic (ROC) curve was used to analyze the predictive value of enhanced CT image texture parameters combined with serum CEA and CA724 for postoperative recurrence and metastasis of patients with esophageal cancer. Results: The arterial stage entropy in the recurrence and metastasis group was higher than that in the non-recurrence and metastasis group (P<0.05). The inevenness and entropy of venous phase in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group(P<0.05). The serum CEA and CA724 levels in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group(P<0.05). ROC curve showed that the combination of serum CEA and CA724 had significantly improved the arterial phase entropy, the venous phase unevenness, the area under the curve (AUC) of the entropy, the sensitivity and the specificity compared with the single application of each index, and the combined application had higher predictive efficiency. Conclusion: The serum CEA and CA724 levels and the increase of the entropy and the inhomogeneity and the arterial phase entropy and the inhomogeneity and the entropy of venous phase are related to the recurrence and metastasis of the postoperative patients with esophageal cancer. The combination of the arterial phase entropy and the inhomogeneity and the entropy of venous phase with the serum CEA and CA724 has of high application value in predicting the recurrence and metastasis of the postoperative patients with esophageal cancer.
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