Department of radiology, Anqing Municipal Hospital, Anqing, 246000, Anhui province, China.
Abdom Radiol (NY). 2024 Sep;49(9):2996-3002. doi: 10.1007/s00261-024-04286-9. Epub 2024 Mar 25.
To explore the diagnostic value of dual-source computed tomography (DSCT) and neutrophil to lymphocyte ratio (NLR) for differentiating gastric signet ring cell carcinoma (SRC) from mixed SRC (mSRC) and non-SRC (nSRC).
This retrospective study included patients with gastric adenocarcinoma who underwent DSCT between August 2019 and June 2021 at our Hospital. The iodine concentration in the venous phase (IC), standardized iodine concentration (NIC), and the slope of the energy spectrum curve (k) were extracted from DSCT data. NLR was determined from laboratory results. DSCT (including IC, NIC, and k) and combination (including DSCT model and NLR) models were established based on the multinomial logistic regression analysis. The receiver operator characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic value.
A total of 155 patients (SRC [n = 45, aged 61.22 ± 11.4 years], mSRC [n = 60, aged 61.09 ± 12.7 years], and nSRC [n = 50, aged 67.66 ± 8.76 years]) were included. There were significant differences in NLR, IC, NIC, and k among the SRC, mSRC, and nSRC groups (all P < 0.001). The AUC of the combination model for SRC vs. mSRC + nSRC was 0.964 (95% CI: 0.923-1.000), with a sensitivity of 98.3% and a specificity of 86.7%, higher than with DSCT (AUC: 0.959, 95% CI: 0.919-0.998, sensitivity: 90.0%, specificity: 89.9%) or NLR (AUC: 0.670, 95% CI: 0.577-0.768, sensitivity: 62.2%, specificity: 61.8%).
DSCT combined with NLR showed high diagnostic efficacy in differentiating SRC from mSRC and nSRC.
探讨双源 CT（DSCT）与中性粒细胞与淋巴细胞比值（NLR）对胃印戒细胞癌（SRC）与混合 SRC（mSRC）和非-SRC（nSRC）的鉴别诊断价值。
本回顾性研究纳入了 2019 年 8 月至 2021 年 6 月在我院接受 DSCT 检查的胃腺癌患者。从 DSCT 数据中提取静脉期碘浓度（IC）、标准化碘浓度（NIC）和能谱曲线斜率（k）。NLR 由实验室结果确定。基于多项逻辑回归分析，建立 DSCT（包括 IC、NIC 和 k）和联合（包括 DSCT 模型和 NLR）模型。采用受试者工作特征（ROC）曲线和曲线下面积（AUC）评估诊断价值。
共纳入 155 例患者（SRC [n=45，年龄 61.22±11.4 岁]、mSRC [n=60，年龄 61.09±12.7 岁]和 nSRC [n=50，年龄 67.66±8.76 岁]）。SRC、mSRC 和 nSRC 组间 NLR、IC、NIC 和 k 差异均有统计学意义（均 P<0.001）。SRC 与 mSRC+nSRC 联合模型的 AUC 为 0.964（95%CI：0.923-1.000），敏感性为 98.3%，特异性为 86.7%，高于 DSCT（AUC：0.959，95%CI：0.919-0.998，敏感性：90.0%，特异性：89.9%）或 NLR（AUC：0.670，95%CI：0.577-0.768，敏感性：62.2%，特异性：61.8%）。
DSCT 联合 NLR 对 SRC 与 mSRC 和 nSRC 的鉴别诊断具有较高的诊断效能。
