结直肠腺癌CT表现特征与其病理组织学特征的关系分析
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摘要
目的:探讨结直肠腺癌CT表现特征与其病理组织学特征的关系。方法:选取2017年1月-2018年1月本院结直肠腺癌患者169例,同期溃疡性结肠炎患者100例,均给予CT增强扫描并通过纹理分析法检测平均值、峰值、偏度、标准差、熵、不均匀度等定量CT表现特征,分析结直肠腺癌CT表现特征与其病理组织学特征的关系。结果:直肠腺癌组标准差、熵、不均匀度均明显高于溃疡性结肠炎组(P<0.05),两组平均值、峰值、偏度比较差异均无统计学意义(P>0.05);标准差、熵、不均匀度均与淋巴结转移、TNM分期、浸润深度、分化程度有关(P<0.05),平均值、峰值、偏度均与病理组织学特征无关(P>0.05)。结论:结直肠腺癌CT纹理分析的表现特征与其病理组织学特征有关,其中标准差、熵、不均匀度可作为评估结直肠腺癌生物学特性的重要指标。
Objective:To discuss the relationship between CT features and histopathological features of colorectal adenocarcinoma.Method:A total of 169 patients with colorectal adenocarcinoma from January 2017 to January 2018 in our hospital were selected,100 patients with ulcerative colitis were selected at the same time were selected.All patients were given CT enhanced scan and detected by means of texture analysis for mean value,peak,skewness,standard deviation,entropy,inhomogeneity and other quantitative CT features.The relationship between CT features and histopathological features of colorectal adenocarcinoma were analyzed.Result:The standard deviation,entropy and heterogeneity of colorectal adenocarcinoma group were significantly higher than those of ulcerative colitis group,the differences were statistically significant(P<0.05);the mean value,peak and skewness in two groups were compared,the differences were not statistically significant(P>0.05).The standard deviation,entropy and inhomogeneity were related to lymph node metastasis,TNM stage,depth of invasion and degree of differentiation(P<0.05);the mean value,peak value and skewness were not related to histopathological characteristics(P>0.05).Conclusion:CT features of colorectal adenocarcinoma are related to their histopathological features,the standard deviation,entropy and heterogeneity can be used as an important indicator for evaluating the biological characteristics of colorectal adenocarcinoma.
Objective:To discuss the relationship between CT features and histopathological features of colorectal adenocarcinoma.Method:A total of 169 patients with colorectal adenocarcinoma from January 2017 to January 2018 in our hospital were selected,100 patients with ulcerative colitis were selected at the same time were selected.All patients were given CT enhanced scan and detected by means of texture analysis for mean value,peak,skewness,standard deviation,entropy,inhomogeneity and other quantitative CT features.The relationship between CT features and histopathological features of colorectal adenocarcinoma were analyzed.Result:The standard deviation,entropy and heterogeneity of colorectal adenocarcinoma group were significantly higher than those of ulcerative colitis group,the differences were statistically significant(P<0.05);the mean value,peak and skewness in two groups were compared,the differences were not statistically significant(P>0.05).The standard deviation,entropy and inhomogeneity were related to lymph node metastasis,TNM stage,depth of invasion and degree of differentiation(P<0.05);the mean value,peak value and skewness were not related to histopathological characteristics(P>0.05).Conclusion:CT features of colorectal adenocarcinoma are related to their histopathological features,the standard deviation,entropy and heterogeneity can be used as an important indicator for evaluating the biological characteristics of colorectal adenocarcinoma.
引文
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[18]王国蓉,王志伟,薛华丹,等.CT纹理分析对鉴别直肠癌患者K-ras基因突变的可行性研究[J].放射学实践,2017,32(12):1215-1220.
[2]Siegmund B.Management of Mild-to-Moderate U lcerative[J].Colitis Dig Dis,2015,33(S1):90-94.
[3]陈子敏,李振辉,董兴祥,等.结直肠黏液腺癌的CT表现[J].中国临床医学影像杂志,2016,27(10):729-731,735.
[4]黄燕琪,马泽兰,何兰,等.基于CT图像的纹理分析鉴别肝脏实性局灶性病变[J].中国医学影像学杂志,2016,24(4):289-292,297.
[5]Probert C S,Dignass A U,Lindgren S,et al.Combined oral and rectal mesalazine for the treatment of mild-to-moderately active ulcerative colitis:Rapid symptom remlution and improvements in quality of life[J].J Crohns CoIitis,2014,8(3):200-207.
[6]Bochis O V,Irimie A,Pichler M,et al.The role of Skp2 and its substrate CDKN1B(p27)in colorectal cancer[J].J Gastrointestin Liver Dis,2015,24(2):225-234.
[7]王笑,所世腾,朱炯,等.肠道CT图像纹理分析和非线性判别分析在结直肠癌及溃疡性结肠炎判别诊断中的应用[J].上海交通大学学报(医学版),2018,38(6):624-631.
[8]McGregor M J,Fadhil W,Wharton R,et al.Aberrant P53Expres-sion Lacks Prognostic or Predictive Significance in Colorectal Cancer:Results from the VICTOR Trial[J].Anticancer Res,2015,35(3):1641-1645.
[9]董亮,钱震,施蓉蓉,等.结直肠腺癌组织中p53、HER-2和Ki-67的表达及其临床病理意义[J].诊断病理学杂志,2015,22(1):19-22,26.
[10]卜庆丰,张杰,胡平,等.低张水灌肠螺旋CT双期增强扫描对结肠癌的诊断价值及应用[J].中国医学创新,2014,11(10):18-20.
[11]李鹍,李振辉,张治平,等.结直肠腺癌组织学分级与CT表现的关系[J].放射学实践,2017,32(11):1175-1178.
[12]钟井松,胡春洪,沈海林.良、恶性胰腺导管内乳头状黏液性肿瘤CT特征与病理联系[J].临床放射学杂志,2015,34(1):66-69.
[13]刘露,吴霜,伍兵.CT图像纹理分析鉴别肝上皮样血管内皮瘤与结肠癌肝转移瘤的初步研究[J].中国普外基础与临床杂志,2018,25(4):483-487.
[14]刘慧,王小宜,龙学颖.基于CT图像纹理分析肿瘤异质性的研究进展及应用[J].国际医学放射学杂志,2016,39(5):543-548.
[15]迟淑萍.CT图像纹理分析在鉴别良恶性肺结节中的价值[J].实用放射学杂志,2016,32(11):1789-1792.
[16]李清,稽昀,武江芬,等.CT纹理分析在鉴别乏脂肪肾错构瘤与肾透明细胞癌中的价值[J].临床放射学杂志,2017,36(7):993-997.
[17]颜智敏,冯智超,曹鹏,等.多层螺旋CT图像纹理分析对直肠癌转移性淋巴结的诊断价值[J].中华放射学杂志,2017,51(6):432-436.
[18]王国蓉,王志伟,薛华丹,等.CT纹理分析对鉴别直肠癌患者K-ras基因突变的可行性研究[J].放射学实践,2017,32(12):1215-1220.