标题：多期增强MSCT测量的结肠癌肿瘤大小与脉管癌栓的相关性

      作者：李胜 1，李建业 1，葛建国 2    古田县医院医学影像科 1、外科 2，福建 宁德 352200

      卷次： 2022年33卷1期

      【摘要】 目的 探讨多期增强多层螺旋 CT (MSCT)测量的结肠癌肿瘤大小与脉管癌栓(LVI)的相关性。方法 选择 2016年 1月至 2020年 12月古田县医院收治的 60例结肠癌患者为研究对象，依据病理结果将患者分为 LVI阴性组 49例和 LVI阳性组 11例。采用MSCT检查并比较两组患者的肿瘤体积(Tvol)、肿瘤的最大面积(Tare)、肿瘤的最大直径(Tdia)、肿瘤长度(Tlen)，应用Spearman相关分析法分析其与LVI的相关性。以病理结果作为金标准，分析肿瘤大小的测量在LVI阳性患者中的诊断效能。结果 LVI阴性组患者的Tvol、Tare、Tdia及Tlen分别为(25.73±4.39) cm3、(8.86±2.86) cm2、(1.53±0.48) cm、(4.41±1.38) cm，明显低于阳性组的(56.69±4.83) cm3、(16.03±3.28) cm2、(2.02±0.57) cm、(6.21±2.03) cm，差异均有统计学意义(P<0.05)；Tvol、Tare、Tdia、Tlen、N分期、T分期、分化程度、肿瘤位置圴与LVI具有明显的相关性(r=0.391，0.355，0.405，0.501，0.327，0.302，0.292，0.406，P<0.05)；以病理结果作为金标准，MSCT检查中Tvol诊断LVI阳性患者的准确度、特异度、敏感度、AUC面积分别为81.37%、83.92%、68.42%、0.839，Tare的准确度、特异度、敏感度、AUC面积分别为81.37%、87.54%、63.26%、0.811，Tdia的准确度、特异度、敏感度、AUC面积分别为70.73%、71.48%、73.75%、0.768，Tlen的准确度、特异度、敏感度、AUC面积分别为69.36%、69.67%、78.93%、0.740；四者相比较，Tvol对LVI阳性患者的诊断效能明显高于Tare、Tdia、Tlen，差异有统计学意义(P<0.05)。结论 结肠癌患者Tvol、Tare、Tdia、Tlen与LVI密切相关，其中Tvol的诊断效能最高。
      【关键词】 多层螺旋CT；肿瘤；结肠癌；脉管癌栓；相关性；诊断效能
      【中图分类号】 R735.3+5 【文献标识码】 A 【文章编号】 1003—6350（2022）01—0083—04

Correlation between tumor size of colon cancer measured by multiphase enhanced MSCT and vascular tumorthrombus.
LI Sheng 1, LI Jian-ye 1, GE Jian-guo 2. Department of Medical Imaging 1, Department of Surgery 2, GutianHospital of Fujian Province, Ningde 352200, Fujian, CHINA
【Abstract】 Objective To analyze the application of multiphase enhanced MSCT in tumor size measurementof colon cancer and its correlation with lymphovascular invasion (LVI). Methods Sixty colon cancer patients in GutianHospital of Fujian Province from January 2016 to December 2020 were selected as the research objects. According to thepathological results, the patients were divided into LVI negative (49 cases) group and LVI positive (11 cases) group. Allpatients underwent multiphase enhanced multi-slice spiral CT (MSCT) examination, and tumor volume (Tvol), maxi-mum tumor area (Tare), maximum tumor diameter (Tdia), and tumor length (Tlen) were compared within the group. Thecorrelation between LVI and MSCT was analyzed by Spearman. Taking the pathological results as the gold standard, thediagnostic efficacy of tumor size measurement in LVI positive patients was analyzed. Results Tvol, Tare, Tdia, andTlen in LVI negative group were (25.73±4.39) cm3, (8.86±2.86) cm2, (1.53±0.48) cm, (4.41±1.38) cm, which were signif-icantly lower than (56.69±4.83) cm3, (16.03±3.28) cm2, (2.02±0.57) cm, (6.21±2.03) cm in LVI positive group (P<0.05).Tvol, Tare, Tdia, Tlen, N stage, T stage, degree of differentiation, and tumor location were significantly correlated withLVI (r=0.391, 0.355, 0.405, 0.501, 0.327, 0.302, 0.292, 0.406, P<0.05). Taking pathological results as the gold standard,the accuracy, specificity, sensitivity, and AUC area in diagnosing LVI positive patients in MSCT were 81.37%, 83.92%,68.42%, and 0.839 for Tvol, 81.37%, 87.54%, 63.26% and 0.811 for Tare, 70.73%, 71.48%, 73.75%, and 0.768 for Tdia,and 69.36%, 69.67%, 78.93%, and 0.740 for Tlen, respectively. The diagnostic efficacy of Tvol in LVI positive patientswas significantly higher than that of Tare, Tdia, and Tlen (P<0.05). Conclusion The tumor size of Tvol, Tare, Tdia, andTlen is closely related to LVI in patients with colon cancer, and the diagnostic efficiency of Tvol is the highest.
      【Key words】 Multi-slice spiral CT; Tumor; Colon cancer; Lymphovascular invasion; Relevance; Diagnostic effi-ciency