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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.
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：血管生成是大肠癌生长的关键步骤，进展和转移。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关联。
方法：本回顾性分析包括42例结直肠腺癌患者。微血管密度（MVD）的中位数作为临界值，将42例患者分为高密度组(MVD≥35/场，n=24)和低密度组(MVD<35/场，n=18),收集25例结直肠良性病变患者作为对照组。CER的统计分析，CT灌注参数,在所有组进行血清标记。绘制受试者工作曲线(ROC),评价相关CT灌注参数对肿瘤血管生成的诊断效能;Pearson相关分析探讨CER,CT灌注参数和血清标志物。
结果：CER，血容量（BV），血流量（BF），渗透性表面（PS）和糖类抗原19-9（CA19-9），糖类抗原125(CA125),癌胚抗原(CEA),三叶因子3(TFF3)，血管内皮生长因子(VEGF)在结直肠腺癌中的表达明显高于对照组,高密度组各项指标均显著高于低密度组(P<0.05);结直肠腺癌患者的达峰时间(TTP)明显低于对照组,与低密度组相比，高密度组的水平明显降低（P<0.05）。组合参数BF+TTP+PS和BV+BF+TTP+PS表现出最高的曲线下面积(AUC),都在0.991。Pearson相关分析显示,血清CA19-9、CA125、CEA、TFF3和VEGF与CER呈正相关,BV,BF,和PS（P<0.05），这些指标与TTP呈负相关(P<0.05)。
结论：术前一些单一和联合CT灌注参数可以准确预测结直肠腺癌的肿瘤血管生成。术前CER和CT灌注参数与血清标志物有一定关联。
方法：本回顾性分析包括42例结直肠腺癌患者。微血管密度（MVD）的中位数作为临界值，将42例患者分为高密度组(MVD≥35/场，n=24)和低密度组(MVD<35/场，n=18),收集25例结直肠良性病变患者作为对照组。CER的统计分析，CT灌注参数,在所有组进行血清标记。绘制受试者工作曲线(ROC),评价相关CT灌注参数对肿瘤血管生成的诊断效能;Pearson相关分析探讨CER,CT灌注参数和血清标志物。
结果：CER，血容量（BV），血流量（BF），渗透性表面（PS）和糖类抗原19-9（CA19-9），糖类抗原125(CA125),癌胚抗原(CEA),三叶因子3(TFF3)，血管内皮生长因子(VEGF)在结直肠腺癌中的表达明显高于对照组,高密度组各项指标均显著高于低密度组(P<0.05);结直肠腺癌患者的达峰时间(TTP)明显低于对照组,与低密度组相比，高密度组的水平明显降低（P<0.05）。组合参数BF+TTP+PS和BV+BF+TTP+PS表现出最高的曲线下面积(AUC),都在0.991。Pearson相关分析显示,血清CA19-9、CA125、CEA、TFF3和VEGF与CER呈正相关,BV,BF,和PS（P<0.05），这些指标与TTP呈负相关(P<0.05)。
结论：术前一些单一和联合CT灌注参数可以准确预测结直肠腺癌的肿瘤血管生成。术前CER和CT灌注参数与血清标志物有一定关联。
