Correlation Between CT-based Extracellular Volume Fraction Combined With NLR And Pathological Grade Of Colon Carcinoma

Objective:(1)To explore the correlation between ECV,NLR,CEA,CA199 and pathological grade of colon cancer;(2)To explore the value of ECV combined with NLR,CEA,and CA199 in predicting pathological grade of colon cancer.Methods: A retrospective collection of 102 patients diagnosed with colon cancer after postoperative pathological examination in the First Affiliated Hospital of Shihezi University from January 2019 to December 2021 was retrospectively collected,and multi-stage dynamic contrast-enhanced CT scan of the abdomen was collected.Two senior diagnostic imaging physicians measured and calculated the collected CT images,recorded the CT values of colon carcinoma lesions and aortic stage two stages in plain scanning and balance,and calculated the CT difference and extracellular volume fraction(ECV)of colon carcinoma lesions and aorta.Fasting venous blood was drawn from all study subjects,blood count,CEA,CA199 were measured,and neutrophil to lymphocyte ratio(NLR)was calculated.All cases were classified according to the World Health Organization(WHO)classification(5th edition)adenocarcinoma grading scale,with poorly differentiated and undifferentiated groups included in the high-grade ratio group and moderately differentiated and high-differentiation into the low-grade group.The clinical data and imaging parameters of the patient,namely the patient’s age,gender,lesion site,hematocrit,ECV,CT difference(CE),NLR,CEA,CA199,were compared between groups.Spearman rank correlation analysis evaluated the correlation between ECV,CE,NLR,CEA,CA199 and pathological grade of colon cancer.The ROC curve was used to compare the diagnostic performance of ECV and CE in predicting the pathological grade of colon cancer.To analyze the differences between ECV,NLR,CEA and CA199 in the pathological grading groups of colon cancer patients,and a logistic regression model was established to analyze its value in predicting pathological grade in colon cancer patients.Results:(1)In the analysis of the general clinical and imaging characteristics of patients,there was no significant significance in terms of age,sex and hematocrit between the two groups(P>0.05),The differences in lesion site,ECV,CE,NLR,CEA,and CA199 between high-grade and low-grade groups were statistically significant(all P<0.05).(2)ECV,CE,NLR,CEA,CA199 were positively correlated with the pathological grade of colon cancer(r=0.471,0.322,0.317,0.224,0.447,all P<0.05).(3)ECV predicted the AUC of pathological grade of colon cancer was 0.816,which was greater than that of CE(0.716)(all P<0.05).(4)Multivariate regression analysis shows that ECV,NLR,and CA199 were independent risk factors for predicting pathological grade of colon cancer(all P<0.05).The regression equation is established as follows: Logit(P)=0.180×ECV+0.568×NLR+0.066×CA199-10.210.The AUC of the joint predictive model is 0.903,which is higher than the AUC of either of the separately detected indicators(all P<0.05).The results of this prediction model were consistent with pathology(Kappa=0.628,P<0.05).Conclusions: ECV,CE,NLR,CEA,CA199 were positively correlated with the pathological grade of colon cancer.Compared with CE,ECV has higher diagnostic value in predicting pathological grade of colon cancer.Compared with single detection,the combined detection of ECV,NLR,and CA199 can improve the prediction of pathological grade of colon cancer.