【摘要】 目的 探讨能谱CT参数联合骨代谢标志物检测对脊柱转移肿瘤的诊断价值。方法 将106例疑似脊柱转移肿瘤患者根据病理结果分为脊柱转移肿瘤组（n=66）和非脊柱转移肿瘤组（n=40）。两组患者均进行能谱CT扫描，计算能谱曲线斜率（k）、标准化碘浓度（NIC）。检测并比较两组患者的骨特异性碱性磷酸酶（BAP）、总Ⅰ型原胶原N-端前肽（tP1NP）及β-Ⅰ型胶原C-末端肽交联（β-CTX）水平。脊柱转移肿瘤患者能谱CT参数与骨代谢标志物的相关性采用Pearson相关分析。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），评估能谱CT参数、骨代谢标志物单独及联合检测对脊柱转移肿瘤的诊断价值。结果 脊柱转移肿瘤组患者的k、NIC及BAP、tP1NP、β-CTX水平均明显高于非脊柱转移肿瘤组，差异均有统计学意义（P﹤0.01）。Pearson相关分析结果显示，脊柱转移肿瘤患者的k、NIC与BAP、t P1NP及β-CTX均呈正相关（P﹤0.05）。ROC曲线显示，5项指标（k+NIC+BAP+tP1NP+β-CTX）联合检测诊断脊柱转移肿瘤的AUC为0.890，高于各指标单独检测。结论 脊柱转移肿瘤患者能谱CT参数和骨代谢标志物水平均较高，且二者具有一定的相关性，其联合检测对脊柱转移肿瘤具有较高的诊断价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of spectral CT parameters combined with bone metabolism markers detection for spinal metastasis tumors. Method A total of 106 patients with suspected spinal metastasis tumors were selected and divided into spinal metastasis tumor group(n=66) and non-spinal metastasis tumor group(n=40) according to pathological results. Both groups underwent spectral CT scans. The slope of the energy spectrum curve(k) and the normalized iodine concentration(NIC) were calculated. The bone-specific alkaline phosphatase(BAP), total N-terminal propeptide of type I precollagen(tP1NP), and C-terminal telopeptide of β type I collagen(β-CTX) levels were detected and compared between the two groups. The correlation between spectral CT parameters and bone metabolism markers in patients with spinal metastasis tumors was analyzed using Pearson correlation. Receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC) was calculated to evaluate the diagnostic value of spectral CT parameters and bone metabolism markers alone and in combination detection for spinal metastasis tumors. Result The k,NIC, and levels of BAP, tP1NP, and β-CTX in the spinal metastasis tumor group were significantly higher than those in the non-spinal metastasis tumor group, and the differences were statistically significant(P<0.01). Pearson correlation analysis results showed that k, NIC were positively correlated with BAP, tP1NP and β-CTX in patients with spinal metastasis tumors(P<0.05). The ROC curve showed that the AUC of the combined detection of five indicators(k + NIC + BAP +tP1NP+β-CTX) in diagnosing spinal metastasis tumors was 0.890, which was higher than the detection of each single indicator. Conclusion Spectral CT parameters and bone metabolism marker levels are higher in patients with spinal metastasis tumors, and there is a certain correlation between them. Their combined detection has high diagnostic value for spinal metastasis tumors.更多还原