双源双能量CT碘图定量预测纯磨玻璃样肺腺癌浸润性 与MVD和Ki-67表达水平的相关研究
摘要
Ki-67的相关性。方法:收集经病理证实并行胸部双源双能量增强CT扫描43例患者共65个pGGNs病灶，分为腺
体前驱病变组(31个）和浸润性肺腺癌组(34个）。分析双能量CT碘图参数时分别在动、静脉期测量病灶MixCT
值、overlay值、碘含量(IC）。同时，收集病灶免疫组化参数(MVD值和Ki-67表达水平）。将具有统计学意义的参
数纳入logistic回归模型分析，绘制ROC曲线，得到AUC。以Spearman相关检验分析影像学参数与MVD、Ki-67相
关性。结果:(1）双能量CT碘图参数中，浸润性肺腺癌组的静脉期IC高于腺体前驱病变组，差异有统计学意义(P
＜0.05）。(2）logistic回归分析中，长径和静脉期IC是预测pGGNs样肺腺癌浸润性的独立危险因素，IC的ROC曲线
显示较好的诊断性能(AUC为0.750，敏感度为79.4%，特异度为61.3%）。(3）浸润性肺腺癌组MVD、Ki-67值均高
于腺体前驱病变组，差异有统计学意义(P＜0.01）。(4）静脉期IC与MVD具有中等相关性(r=0.515，P＜0.001），
静脉期IC与Ki-67表达水平具有弱相关性(r=0.391，P=0.010）;长径与Ki-67表达水平具有中等相关性(r=0.548，
P＜0.001），与MVD具有弱相关性(r=0.270，P=0.030）。结论:双源双能量增强CT碘图中静脉期IC对pGGNs浸润
性预测价值较好，且静脉期IC与MVD值、长径与Ki-67表达水平具有密切相关性，有助于无创性评估肺腺癌的血
管生成及细胞增殖水平。
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