Value of dual-energy CT quantitative parameters combined with clinical features in diagnosis of stages T2 and T3 colorectal cancer

FANG Ni; WEI Xin; CHEN Weijuan; FENG Mei; ZHANG Lingjing; LIU Yuexi; LAI Qi; DING Xuan; LIU Xinjie; JIANG Wei; YU Han

doi:10.16016/j.2097-0927.202408035

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Value of dual-energy CT quantitative parameters combined with clinical features in diagnosis of stages T2 and T3 colorectal cancer

Clinical Medicine | 更新时间：2025-01-23

- Value of dual-energy CT quantitative parameters combined with clinical features in diagnosis of stages T2 and T3 colorectal cancer
- Journal of Army Medical University Vol. 47, Issue 2, Pages: 177-185(2025)
- 作者机构：
  
  重庆医科大学附属第二医院放射科，重庆
- 作者简介：
  
  YU Han， E-mail： 304457@hospital.cqmu.edu.cn
- 基金信息：
  
  the Joint General Project of Chongqing Science and Technology Commission and Chongqing Health Commission(2022MSXM136);the Lenient Horizontal Project of the Second Affiliated Hospital of Chongqing Medical University(2023HX014)
- DOI：10.16016/j.2097-0927.202408035
  CLC： R195.4;R735.35;R814.42
- Published：30 January 2025，
  
  Received：09 August 2024，
  
  Revised：15 November 2024，
- 稿件说明：
移动端阅览
FANG NI, WEI XIN, CHEN WEIJUAN, et al. Value of dual-energy CT quantitative parameters combined with clinical features in diagnosis of stages T2 and T3 colorectal cancer. [J]. Journal of army medical university, 2025, 47(2): 177-185.
DOI：

FANG NI, WEI XIN, CHEN WEIJUAN, et al. Value of dual-energy CT quantitative parameters combined with clinical features in diagnosis of stages T2 and T3 colorectal cancer. [J]. Journal of army medical university, 2025, 47(2): 177-185. DOI： 10.16016/j.2097-0927.202408035.

摘要

目的

探讨双能CT定量参数联合临床特征构建的回归模型对结直肠癌T2期与T3期分期的诊断价值。

方法

该研究为横断面研究，收集2022年1月至2023年11月在重庆医科大学附属第二医院经术后病理证实，术前在本院放射科行双能CT检查的结直肠癌患者，共91例，根据中国结直肠癌诊疗规范（2020年版）病理T分期标准分为T2组（

=43）和T3（

=48）组。采用单因素分析比较2组间CT定量参数和临床特征的差异性，将差异具有统计学意义的变量采用单因素或多因素Logistic回归分析构建模型，并比较CT参数模型和联合模型的AUC，评估诊断T2期及T3期的效能。

结果

单因素分析发现癌胚抗原、N分期、肿瘤位置、肿瘤长径、虚拟平扫CT值、脂肪分数、电子密度及双能指数在T2组与T3组间差异具有统计学意义（

＜0.05）。多因素Logistic分析发现N分期、肿瘤位置、肿瘤长径、脂肪分数和双能指数是诊断T3期的独立危险因素，将以上变量分别构建CT参数模型和CT参数+临床特征联合模型，其中CT参数模型诊断结直肠癌T3期的AUC为0.671（95%

： 0.558~0.783），联合模型的AUC为0.886（95%

： 0.815~0.957），且联合模型AUC值与CT参数模型AUC值间差异具有统计学意义（

＜0.01）。

结论

双能CT定量参数联合临床特征构建的回归模型对术前诊断结直肠癌T2期与T3期分期具有较高价值。

Abstract

Objective‍　‍To investigate the diagnostic value of our regression model based on quantitative parameters of dual-energy CT and clinical features for stages T2 and T3 colorectal cancer. Methods‍　‍A cross-section study was performed on 91 patients with colorectal cancer confirmed by postoperative pathology in our hospital from January 2022 to November 2023. All of them underwent dual-energy CT examination. According to the pathological T staging criteria of Chinese Colorectal Cancer Diagnosis and Treatment Standard （2020 Edition）， they were divided into T2 group （

=43） and T3 group （

=48）. Univariate analysis was used to compare the differences in quantitative CT parameters and clin

ical features between the 2 groups， and the obtained significant variables were employed to construct diagnosis models by univariate or multivariate logistic regression analysis. The area under receiver operating characteristic curve （AUC） of the CT parametric model and the model combined with clinical features was compared to evaluate the efficacy of diagnosing T2 and T3 stages. Results‍　‍Univariate analysis showed that carcinoembryonic antigen （CEA）， N stage， tumor location， tumor longest diameter （LD）， CT value of virtual noncontrast （CT-VNC）， fat fraction， electron density （Rho） and dual energy index （DEI） were significantly different between the T2 and T3 groups （

0.05）. Multivariate logistic regression analysis found that N stage， tumor location， LD， fat fraction and DEI were independent risk factors for the diagnosis of stage T3. The AUC value of the model of above CT parameters in diagnosing stage T3 colorectal cancer was 0.671 （95%

： 0.558~0.783）， and the AUC value of the combined model of above CT parameters and clinical features was 0.886 （95%

： 0.815~0.957）， and statistical difference was observed in the AUC value between the combined model and the CT parametric model （

0.01）. Conclusion‍　‍The regression model constructed with dual-energy CT quantitative parameters combined with clinical features has high value in the preoperative diagnosis of stages T2 and T3 colorectal cancer before surgery.

关键词

结直肠肿瘤T分期体层摄影术，X线计算机双能量成像

Keywords

colorectal tumorT stagetomography， X-ray computerdual energy imaging

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