Clinical Prognosis Of Gastric Cancer Based On Arterial Phase CT Texture Analysis And HER2 Protein Expression

Objective To explore the relationship between CT texture analysis of gastric cancer,HER2 protein expression and clinical prognosis,so as to improve and expand the role of CT examination.Methods A retrospective analysis was made on 39 patients with gastric cancer confirmed by surgery and pathology who were admitted to the First People’s Hospital of Kashi Region in Xinjiang from Oct.2014 to Oct.2017,including 32 males and 7 females,aged 26.0 to 77.0 years old,with an average age of 56.7 years old.The patients were divided into two groups according to their pathological data:HER2 negative group and positive group,and early and advanced gastric cancer group.PACS system was used to measure the largest diameter of tumor on axial CT and record the survival time of the follow-up patients.CT texture parameters of arterial phase primary lesion were measured by3DSlicer-Radiomics CT texture analysis software,including mean,skewness,kurtosis,entropy,median,10 and 90 percentiles.Two independent samples t test or Mann-Whitney U test were used to compare the difference of texture parameters between the two groups.P < 0.05 indicates the statistical significance.Results1.The data of this group show that the maximum diameter line of patients with early gastric cancer ranged from 4.32~5.36 cm,showing 1.85~2.97 survival years,with an average survival time of2.41 years while the maximum diameter line of advanced gastric cancer fell into 6.16~7.01 cm,showing 1.00 ~ 1.42 survival years with an average survival time of 1.21 years.The average difference between the survival time of patients with early and advanced gastric cancer is 1.2 years.The difference in the maximum diameter line and survival time of tumors between the two groups is statistically significant(P <0.05).2.CT arterial phase texture parameters showed that the 10 th percentile,90 th percentile,median and average of HER2 negative group were lower than those of positive group,and the difference between the two groups was statistically significant(P <0.05),while the differences in skewness,kurtosis and entropy between the two groups were not statistically significant(P >0.05).There was no significant difference in the 10 th percentile,90 th percentile,median,mean,skewness,kurtosis and entropy between the early and advanced gastric cancer group(P >0.05).3.The ROC curve was used to analyze the 10 th and 90 th percentiles,mean and median of the arterial phase of CT enhanced scanning,and it was found that the optimal thresholds were 13.5,70.2,39.4and 24.3,respectively,and the AUC was approximately0.733~0.813 are of definite diagnostic value in differentiating HER2 negative and positive gastric cancer,among which the 90 th percentile has the highest diagnostic efficiency.Conclusions The maximum diameter of early gastric cancer was shorter than that of advanced gastric cancer on axial CT,and its survival time was longer.Arterial phase CT images texture analysis could help to further understand the biological behavior of gastric cancer.