Yang Xieqing, Hu Huijun, Zhang Fang, Li Dongye, Yang Zehong, Shi Guangzi, Lu Guoxiong, Jiang Yusong, Yang Lingjie, Wang Yu, Duan Xiaohui, Shen Jun
Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Front Oncol. 2022 Jun 23;12:904471. doi: 10.3389/fonc.2022.904471. eCollection 2022.
To determine whether quantitative parameters derived from dual-energy computed tomography (DECT) were predictive of the aggressiveness of oral tongue squamous cell carcinoma (OTSCC) including the pathologic stages, histologic differentiation, lymph node status, and perineural invasion (PNI).
Between August 2019 and March 2021, 93 patients (mean age, 54.6 ± 13.8 years; 66 men) with pathologically diagnosed OTSCC were enrolled in this prospective study. Preoperative DECT was performed and quantitative parameters (e.g., slope of the spectral Hounsfield unit curve [λ], normalized iodine concentration [nIC], normalized effective atomic number [nZ], and normalized electron density [nRho]) were measured on arterial phase (AP) and venous phase (VP) DECT imaging. Quantitative parameters from DECT were compared between patients with different pathologic stages, histologic differentiation, lymph node statuses, and perineural invasion statuses. Logistic regression analysis was utilized to assess independent parameters and the diagnostic performance was analyzed by the receiver operating characteristic curves (ROC).
λ and nIC in AP and λ, nZ, and nIC in VP were significantly lower in stage III-IV lesions than in stage I-II lesions ( < 0.001 to 0.024). λ in VP was an independent predictor of tumor stage with an odds ratio (OR) of 0.29, and area under the curve (AUC) of 0.80. λ and nIC were higher in well-differentiated lesions than in poorly differentiated lesions ( < 0.001 to 0.021). The nIC in VP was an independent predictor of histologic differentiation with OR of 0.31, and AUC of 0.78. λ and nIC in VP were lower in OTSCCs with lymph node metastasis than those without metastasis ( < 0.001 to 0.005). λ in VP was the independent predictor of lymph node status with OR of 0.42, and AUC of 0.74. No significant difference was found between OTSCCs without PNI and those with PNI in terms of the quantitative DECT parameters.
DECT can be a complementary means for the preoperative prediction of the aggressiveness of OTSCC.
确定双能计算机断层扫描（DECT）得出的定量参数是否可预测口腔舌鳞状细胞癌（OTSCC）的侵袭性，包括病理分期、组织学分化、淋巴结状态和神经周围侵犯（PNI）。
在2019年8月至2021年3月期间，93例经病理诊断为OTSCC的患者（平均年龄54.6±13.8岁；66例男性）纳入了这项前瞻性研究。术前行DECT检查，并在动脉期（AP）和静脉期（VP）DECT成像上测量定量参数（例如，光谱亨氏单位曲线斜率[λ]、归一化碘浓度[nIC]、归一化有效原子序数[nZ]和归一化电子密度[nRho]）。比较不同病理分期、组织学分化、淋巴结状态和神经周围侵犯状态患者的DECT定量参数。采用逻辑回归分析评估独立参数，并通过受试者工作特征曲线（ROC）分析诊断性能。
III-IV期病变的AP期λ和nIC以及VP期的λ、nZ和nIC显著低于I-II期病变（<0.001至0.024）。VP期的λ是肿瘤分期的独立预测因子，比值比（OR）为0.29，曲线下面积（AUC）为0.80。高分化病变的λ和nIC高于低分化病变（<0.001至0.021）。VP期的nIC是组织学分化的独立预测因子，OR为0.31，AUC为0.78。有淋巴结转移的OTSCC的VP期λ和nIC低于无转移者（<0.001至0.005）。VP期的λ是淋巴结状态的独立预测因子，OR为0.42，AUC为0.74。在DECT定量参数方面，无PNI的OTSCC与有PNI的OTSCC之间未发现显著差异。
DECT可作为术前预测OTSCC侵袭性的一种补充手段。
