背景：本研究的目的是探讨能谱计算机断层扫描（CT）成像与宫颈癌的病理特征和预后之间的相关性。
方法：所有参与者均接受能谱CT平扫和宫颈增强扫描，子宫体,和髂总静脉.分析能谱衰减曲线斜率与病理特征及疗效的相关性,并构建了能量谱衰减曲线斜率的接收机工作特性(ROC)曲线,以区分某些病理特征和疗效。
结果：子宫颈的能谱曲线，子宫体,髂总静脉均呈下降趋势。子宫颈能谱曲线斜率在不同分化程度上有显著差异(P<0.05),能谱曲线斜率呈上升趋势。高、低细胞增殖抗原标记物(Ki67)的髂总静脉能谱曲线斜率差异有统计学意义(P<0.05),Ki67高表达的斜率高于Ki67低表达的斜率。17例患者治疗有效，11例无效。治疗后,有效组宫颈能谱曲线斜率和髂总静脉能谱曲线斜率均较治疗前显著升高(P<0.05),无效组子宫颈能谱曲线斜率较治疗前增加,但差异不显著(P>0.05)。髂总静脉能量谱曲线斜率区分Ki67表达的曲线下面积(AUC)为0.7008,敏感性为66.67%,特异性为62.34%。宫颈能谱曲线斜率区分疗效的AUC为0.6131,敏感性为56.25%,特异性为59.09%。髂总静脉能谱曲线斜率区分疗效的AUC为0.6563，灵敏度为60.42%，特异性为58.33%。
结论：能谱曲线斜率在预测宫颈癌特定病理类型和疗效评价方面具有潜在价值。
BACKGROUND: The purpose of this
study is to investigate the correlation between energy spectrum computed tomography (CT) imaging and the pathological characteristics and prognosis of cervical cancer.
METHODS: All participants underwent energy spectrum CT plain scan and enhanced scan of the cervix, uterine body, and common iliac vein. The correlation between the slope of energy spectrum attenuation curve and pathological characteristics and curative effect was analyzed, and the receiver operating characteristic (ROC) curve of the slope of energy spectrum attenuation curve to distinguish some pathological characteristics and curative effect was constructed.
RESULTS: The energy spectrum curves of cervix, uterine body, and common iliac vein all showed a downward trend. The slope of cervix energy spectrum curve showed a significant difference in different differentiation degree (P<0.05), and the slope of energy spectrum curve showed an upward trend. The slope of energy spectrum curve of common iliac vein was significantly different between high and low cell proliferation antigen marker (Ki67) (P<0.05), and the slope of Ki67 high expression was higher than that of Ki67 low expression. Treatment was effective in 17 participants and ineffective in 11. After treatment, the energy spectrum curve slope of cervix and energy spectrum curve slope of common iliac vein in the effective group were significantly increased compared with before treatment (P<0.05), and the energy spectrum curve slope of cervix in the ineffective group was increased compared with before treatment, but the difference was not significant (P>0.05). The area under the curve (AUC) of distinguishing Ki67 expression of energy spectrum curve slope of common iliac vein was 0.7008, sensitivity was 66.67%, and specificity was 62.34%. The AUC of distinguishing the curative effect of cervical energy spectrum curve slope was 0.6131, sensitivity was 56.25%, and specificity was 59.09%. The AUC of distinguishing the curative effect of energy spectrum curve slope of common iliac vein was 0.6563, sensitivity was 60.42%, and specificity was 58.33%.
CONCLUSIONS: The energy spectrum curve slope has potential value in the prediction of certain specific pathological types of cervical cancer and the evaluation of curative effect.
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