术前 CT 增强率及 CT 灌注参数对结直肠癌的预测价值。

Predictive value of preoperative CT enhancement rate and CT perfusion parameters in colorectal cancer.

机构信息

North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, 063000, China.

North China University of Science and Technology, Tangshan, Hebei, 063000, China.

出版信息

BMC Gastroenterol. 2024 May 21;24(1):176. doi: 10.1186/s12876-024-03257-0.

DOI:10.1186/s12876-024-03257-0

PMID:38773485

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11106990/

Abstract

BACKGROUND

Angiogenesis is a critical step in colorectal cancer growth, progression and metastasization. CT are routine imaging examinations for preoperative clinical evaluation in colorectal cancer patients. This study aimed to investigate the predictive value of preoperative CT enhancement rate (CER) and CT perfusion parameters on angiogenesis in colorectal cancer, as well as the association of preoperative CER and CT perfusion parameters with serum markers.

METHODS

This retrospective analysis included 42 patients with colorectal adenocarcinoma. Median of microvessel density (MVD) as the cut-off value, it divided 42 patients into high-density group (MVD ≥ 35/field, n = 24) and low-density group (MVD < 35/field, n = 18), and 25 patients with benign colorectal lesions were collected as the control group. Statistical analysis of CER, CT perfusion parameters, serum markers were performed in all groups. Receiver operating curves (ROC) were plotted to evaluate the diagnostic efficacy of relevant CT perfusion parameters for tumor angiogenesis; Pearson correlation analysis explored potential association between CER, CT perfusion parameters and serum markers.

RESULTS

CER, blood volume (BV), blood flow (BF), permeability surface (PS) and carbohydrate antigen 19 - 9 (CA19-9), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), trefoil factor 3 (TFF3), vascular endothelial growth factor (VEGF) in colorectal adenocarcinoma were significantly higher than those in the control group, the parameters in high-density group were significantly higher than those in the low-density group (P < 0.05); however, the time to peak (TTP) of patients in colorectal adenocarcinoma were significantly lower than those in the control group, and the high-density group showed a significantly lower level compared to the low-density group (P < 0.05). The combined parameters BF + TTP + PS and BV + BF + TTP + PS demonstrated the highest area under the curve (AUC), both at 0.991. Pearson correlation analysis showed that the serum levels of CA19-9, CA125, CEA, TFF3, and VEGF in patients showed positive correlations with CER, BV, BF, and PS (P < 0.05), while these indicators exhibited negative correlations with TTP (P < 0.05).

CONCLUSIONS

Some single and joint preoperative CT perfusion parameters can accurately predict tumor angiogenesis in colorectal adenocarcinoma. Preoperative CER and CT perfusion parameters have certain association with serum markers.

摘要

背景

血管生成是结直肠癌生长、进展和转移的关键步骤。CT 是结直肠癌患者术前临床评估的常规影像学检查。本研究旨在探讨术前 CT 增强率（CER）和 CT 灌注参数对结直肠癌血管生成的预测价值，以及术前 CER 和 CT 灌注参数与血清标志物的相关性。

方法

本回顾性分析纳入 42 例结直肠腺癌患者。以微血管密度（MVD）中位数作为截断值，将 42 例患者分为高密度组（MVD≥35/视野，n=24）和低密度组（MVD<35/视野，n=18），并收集 25 例良性结直肠病变患者作为对照组。对所有组进行 CER、CT 灌注参数和血清标志物的统计学分析。绘制受试者工作特征曲线（ROC）评估相关 CT 灌注参数对肿瘤血管生成的诊断效能；Pearson 相关性分析探讨 CER、CT 灌注参数和血清标志物之间的潜在相关性。

结果

结直肠腺癌的 CER、血容量（BV）、血流（BF）、通透性表面（PS）和癌抗原 19-9（CA19-9）、癌抗原 125（CA125）、癌胚抗原（CEA）、三叶因子 3（TFF3）、血管内皮生长因子（VEGF）明显高于对照组，高密度组明显高于低密度组（P<0.05）；然而，结直肠腺癌患者的达峰时间（TTP）明显低于对照组，且高密度组明显低于低密度组（P<0.05）。BF+TTP+PS 和 BV+BF+TTP+PS 联合参数的曲线下面积（AUC）最高，均为 0.991。Pearson 相关性分析显示，患者的 CA19-9、CA125、CEA、TFF3 和 VEGF 血清水平与 CER、BV、BF 和 PS 呈正相关（P<0.05），而这些指标与 TTP 呈负相关（P<0.05）。