Yue Yali, Hu Feixiang, Hu Tingdan, Sun Yiqun, Tong Tong, Gu Yajia
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, People's Republic of China.
Cancer Manag Res. 2019 Dec 13;11:10445-10453. doi: 10.2147/CMAR.S233595. eCollection 2019.
The objective of this research was to validate the diagnostic value of three-dimensional texture parameters and clinical characteristics in the differentiation of colorectal signet-ring cell carcinoma (SRCC) and adenocarcinoma (AC).
We retrospectively analyzed data from 102 patients with SRCC or AC confirmed by pathology, including 51 SRCC (from January 2015 to July 2019) and 51 AC patients (from January 2019 to July 2019). CT findings and clinical data, including age, gender, clinical symptoms, serological biomarkers, tumor size, and tumor location, were compared between SRCC and AC. CT texture features were quantified on portal phase images using three-dimensional analysis. A list of texture parameters was generated with MaZda software for the classification of tumors. The texture features, clinical data and CT findings were statistically analyzed for the discrimination ability of SRCC and AC, and the potential predictive parameters that may be used to differentiate the two groups were subsequently tested using the least absolute shrinkage and selection operator (LASSO) and logistic regression analyses. The receiver operating characteristic curve (ROC) provided a range of values for establishing the cutoff value, as well as the sensitivity and specificity of prediction for each significant variable.
SRCC occurred more often in men than AC did (80.39% vs 49.02%, P < 0.01). The patients were younger in the SRCC group than in the AC group, without a statistically significant difference (55.84 vs 59.20 years, P = 0.216). There were no significant differences in the clinical symptoms, tumor size, or tumor location between the two groups (P=0.505, P=0.19, P=0.843, respectively). The elevation of serological biomarker CA724 was more common in SRCC than in AC (P< 0.001). Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg were lower in the SRCC group than in the AC group during the portal phase, with the areas under curve (AUCs) of 0.892-0.929, sensitivity of 76.5-84.3% and specificity of 88.2-96.1%. In the differentiation between SRCC and AC, the 1-NN minimal classification error (MCR) was 29.41%.
Three-dimensional texture parameters, including Perc.01%3D, Perc.10%3D and s(1,0,0) SumAverg, exhibited a favorable discriminatory ability to distinguish SRCC from AC.
本研究旨在验证三维纹理参数及临床特征在鉴别结直肠印戒细胞癌（SRCC）和腺癌（AC）中的诊断价值。
我们回顾性分析了102例经病理确诊为SRCC或AC患者的数据，其中包括51例SRCC患者（2015年1月至2019年7月）和51例AC患者（2019年1月至2019年7月）。比较了SRCC和AC患者的CT表现及临床数据，包括年龄、性别、临床症状、血清生物标志物、肿瘤大小及肿瘤位置。在门静脉期图像上采用三维分析对CT纹理特征进行量化。使用MaZda软件生成纹理参数列表以对肿瘤进行分类。对纹理特征、临床数据及CT表现进行统计学分析以评估SRCC和AC的鉴别能力，随后使用最小绝对收缩和选择算子（LASSO）及逻辑回归分析对可能用于区分两组的潜在预测参数进行检验。受试者操作特征曲线（ROC）给出了确定临界值的一系列数值以及每个显著变量预测的敏感性和特异性。
SRCC在男性中的发生率高于AC（80.39%对49.02%，P<0.01）。SRCC组患者比AC组患者年轻，但差异无统计学意义（55.84岁对59.20岁，P=0.216）。两组患者在临床症状、肿瘤大小或肿瘤位置方面无显著差异（分别为P=0.505、P=0.19、P=0.843）。血清生物标志物CA724升高在SRCC中比在AC中更常见（P<0.001）。门静脉期，SRCC组的Perc.01%3D、Perc.10%3D和s(1,0,0)SumAverg低于AC组，曲线下面积（AUC）为0.892 - 0.929，敏感性为76.5 - 84.3%，特异性为88.2 - 96.1%。在SRCC和AC的鉴别中，1 - NN最小分类误差（MCR）为29.41%。
包括Perc.01%3D、Perc.10%3D和s(1,0,0)SumAverg在内的三维纹理参数在区分SRCC和AC方面表现出良好的鉴别能力。
