Diagnostic value of spiral CT arterial enhancement fraction in colorectal cancer staging / 肿瘤研究与临床

ABSTRACT

Objective:To explore the diagnostic value of spiral CT arterial enhancement fraction (AEF) in clinicopathological staging of colorectal cancer.Methods:The clinical data of 151 newly diagnosed colorectal cancer patients (colorectal cancer group) and 86 patients who underwent physical examination with no history of colorectal disease (the control group) admitted to Shanxi Province Cancer Hospital from September 2019 to May 2021 were retrospectively analyzed. All research subjects received whole abdominal spiral CT plain scan and three-phase enhanced scan, and the obtained images were transferred to the Siemens Syngo.via post-processing workstation for post-processing to obtain the AEF color map and its quantitative parameter AEF value. The correlation of AEF value with colorectal cancer stage and Ki-67 was analyzed, and its diagnostic performance for clinicopathological staging of colorectal cancer was evaluated by using receiver operating characteristic curve.Results:The AEF values ??of patients at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ colorectal cancer were (72±9)%, (65±11)%, (60±12)%, and (52±10)%, respectively, and the difference was statistically significant ( F = 22.15, P < 0.001). The AEF values ??of the control group and the colorectal cancer group were (85±6)% and (62±12)%, respectively, and the difference in AEF value of both groups was statistically significant ( t = 18.66, P < 0.001). The clinicopathological stage of colorectal cancer was negatively correlated with AEF value ( r = -0.548, P < 0.05). Taking the control group as the standard, the area under the curve (AUC) of AEF value for the diagnosis of colorectal cancer stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 0.866 (the sensitivity was 62.50%, the specificity was 96.51%) and 0.928 (the sensitivity was 76.74%, the specificity was 98.84%), 0.981 (the sensitivity was 92.68%, the specificity was 91.86%) and 1.000 (the sensitivity was 100.00%, the specificity was 98.84%), and the difference in diagnostic efficiency was statistically significant ( P < 0.05). The AEF value of colorectal cancer was negatively correlated with Ki-67 ( r = -0.537, P < 0.05). The Ki-67 positive index of patients at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ colorectal cancer was (55±12)%, (67±10)%, (73±12)%, and (79±11)%, respectively, and the difference was statistically significant ( F = 11.94, P < 0.001); the Ki-67 positive index of patients at stage Ⅳ was higher than those at stage Ⅰ+Ⅱ ( t = 3.45, P = 0.001); the clinicopathological stage of colorectal cancer was positively correlated with Ki-67 ( r = 0.393, P < 0.001). Conclusions:AEF quantitative color map and AEF value can reflect the characteristics of arterial and venous blood supply in colorectal cancer lesions. AEF value analysis before surgery is helpful for the clinicopathological staging of colorectal cancer.