Objective  Explore the correlation between multi-parameter measurement by 64-slice spiral CT and P53 gene mutation in patients with colorectal cancer.

Methods 150 CRC patients who were diagnosed and treated in Huainan Yangguang Xinkang Hospital from November 2020 to April 2024 were selected, including 89 males and 61 females, aged 29-94 years, with an average age of (64.3±12.0) years old. According to the mutation status of P53 gene, the enrolled patients were divided into mutation group (52 cases) and non-mutation group (98 cases). All patients received 64-slice spiral CT scanning, and multi-parameter measurements of CT images were recorded. The tumor volume, tumor density, enhanced CT value, maximum tumor diameter, tumor morphology, tumor edge and tumor enhancement mode were compared between groups of patients. Chi-square test was used for comparison of enumeration data between groups, and t test was applied for comparison of measurement data conforming to normal distribution between groups. Multivariate Logistic regression analysis was conducted to analyze the independent risk factors affecting P53 mutation in CRC patients, and the diagnostic value of CT multi-parameter measurement on P53 mutation in CRC patients was analyzed by receiver operating characteristic (ROC) curve.

Results Among the 150 CRC patients, there were 52 cases with P53 gene mutation and 98 cases without gene mutation, and the mutation rate of CRC gene was 34.67%. The tumor volume of the mutant group was 45.32±12.81, the tumor density was 37.53±7.22, the enhanced CT value was 78.90±14.37, and the maximum tumor diameter was 7.62±.13. The tumor volume of the non mutant group was 37.32±10.64, the tumor density was 31.68±6.43, the enhanced CT value was 70.56±12.23, and the maximum tumor diameter was 6.01±1.94; The tumor volume (t=4.078, P<0.001), tumor density (t=5.080, P<0.001), CT value after enhancement (t=3.737, P<0.001) and maximum tumor diameter (t=4.675, P<0.001) in the mutation group were larger than those in the non-mutation group. The difference in tumor morphology between the two groups was not statistically significant (χ²=3.366, P=0.067). The proportion of irregular tumor morphology was 31/52 in the mutation group and that in the non-mutation group was 43/98. The proportion of blurred tumor edge in the mutation group was 34/52 and that in the non-mutation group was 24/98. The proportion of blurred tumor edge in the mutation group was significantly higher than that in the non-mutation group (χ²=23.957, P<0.001). The proportion of inhomogeneous tumor enhancement mode with 35/52 in the mutation group was significantly higher than 20/98 in the non-mutation group (χ²=29.732, P<0.001). Multivariate Logistic regression analysis showed that tumor volume (OR=1.165, 95%CI: 1.075−1.263), tumor density (OR=1.059, 95%CI: 1.026−1.092), enhanced CT value (OR=1.046, 95%CI: 1.004−1.090), maximum tumor diameter (OR=1.079, 95%CI: 1.035−1.124), blurred tumor edge (OR=1.079, 95%CI: 1.035−1.124), and inhomogeneous tumor enhancement mode (OR=2.077, 95%CI: 1.358−3.175) were independent risk factors for predicting P53 gene mutation (P<0.05). ROC curve analysis revealed that 64-slice spiral CT multi-parameter combination had high efficiency on the prediction of P53 gene mutation, with an area under the curve of 0.910, a sensitivity of 0.942 and a specificity of 0.796 (P<0.05).

Conclusion 64-slice spiral CT multi-parameter measurement has high efficiency on predicting P53 gene mutations in CRC patients, and can be used as an important reference index for clinical evaluation and guidance of treatment.