摘要目的：探讨双能量投影CT （ dSPCT）预测局部晚期喉及下咽鳞癌（ LHSCC）放疗±化疗疗效的作用。方法前瞻性分析2013—2014年间原发局部晚期LHSCC并行dSPCT扫描患者23例资料，按治疗效果将患者分为完全缓解（ CR）和非完全缓解（ NCR）组；比较两组T分期、治疗方式、碘基物质浓度（ IC－L）、水基物质浓度（ WC－L）、能谱曲线斜率（ s－SHC）的差异，并进行受试者工作特征曲线（ROC）分析。结果 CR和NCR组T分期、治疗方式相近（P＝0．54、1．00），IC－L分别为（15．89±4．08）×102μg／cm3、（20．43±5．98）×102μg／cm3（P＝0．04），WC－L值相近（P＝0．32），s－SHC分别为2．16±0．55、2．77±0．81（P＝0．04）。 IC－L、s－SHC 的ROC下面积分别为0．74、0．72（P＝0．03、0．04）；以IC－L值≤17．44、s－SHC≤2．37作为诊断LHSCC疗效CR标准的敏感性、特异性、Youden指数、阳性似然比、阴性似然比分别为75．0％、72．7％、0．47、2．75、0．34。结论 dSPCT判定局部晚期LHSCC治疗疗效有一定作用。

abstractsObjective To investigate the role of dual-energy scanned projection CT ( dSPCT) in predicting the effect of radiotherapy with or without chemotherapy in the treatment of locally advanced laryngeal and hypopharyngeal squamous cell carcinoma ( LHSCC) .Methods A prospective analysis was performed for the clinical data of 23 patients with primary LHSCC who underwent dSPCT from 2013 to 2014. According to treatment outcome, the patients were divided into complete remission ( CR)group and non-complete remission ( NCR) group.The T stage, treatment modality, iodine concentration of lesion ( IC-L) , water concentration of lesion (WC-L ), and slope of spectral HU curve (s-SHC) were compared between the two groups , and the receiver operating characteristic ( ROC ) curve was also used for analysis .Results There were no significant differences in T stage and treatment modality between the CR group and NCR group ( P=0.54 and P=1.00).The IC-L was (15.89±4.08) ×102 μg/cm3 and (20.43±5.98) ×102 μg/cm3, respectively, in the two groups ( P=0.04) , and the WC-L was similar between the two groups ( P=0.32) . The s-SHC was 2.16±0.55 and 2.77±0.81, respectively, in the two groups ( P=0.04 ) .The areas under the ROC curve for IC-L and s-SHC were 0.74 and 0.72, respectively ( P=0.03 and P=0.04) .The sensitivity, specificity, Youden index, positive likelihood ratio, and negative likelihood ratio of IC-L≤17.44 and s-SHC≤2.37 as the standard for CR in LHSCC were 75.0%, 72.7%, 0.47, 2.75, and 0.34, respectively. Conclusions The dSPCT plays a role in predicting the treatment outcome of locally advanced LHSCC.