非小细胞肺癌CT动态增强扫描定量参数与病理类型及靶向治疗远期预后的关系分析

Relationship between quantitative parameters of CT dynamic contrast-enhanced scan and pathological types,long-term prognosis of targeted therapy in non-small cell lung cancer

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摘要目的:探讨非小细胞肺癌(NSCLC)CT动态增强扫描定量参数与病理类型及靶向治疗远期预后的关系。方法:回顾性分析116例NSCLC患者的临床资料。所有患者均予以作用于表皮生长因子受体(EGFR)的靶向药物治疗,于治疗前和治疗后1个月行CT动态增强扫描,获取定量参数[灌注值、强化峰值(PH)、肿块强化达到峰值时间(Tp)],并根据患者存活情况,分为死亡组(30例)和存活组(86例),分析灌注值、PH、Tp与病理类型及靶向治疗远期预后的关系。结果:治疗前,不同病理类型患者CT动态增强扫描定量参数比较,差异均无统计学意义(均P>0.05)。治疗后,灌注值、PH水平下降,Tp更大(均P<0.05)。治疗后,与死亡组比较,存活组灌注值、PH水平更低,Tp更大(P<0.05)。ROC曲线显示,灌注值预测NSCLC患者远期预后的AUC和截点值分别为0.822、0.19 mL·min^(-1)·mL^(-1),PH预测的AUC和截点值分别为0.780、57.61 HU,Tp预测的AUC和截点值分别为0.741、89.92 s;三者联合预测的AUC为0.960,高于单一参数预测(P<0.05)。结论:NSCLC患者CT动态增强扫描定量参数与病理类型无关,与靶向治疗远期预后密切相关。 Objective:To explore the relationship between quantitative parameters of CT dynamic contrast-enhanced scan and pathological types,long-term prognosis of targeted therapy in non-small cell lung cancer(NSCLC).Methods:A retrospective analysis was performed on the clinical data of 116 patients with NSCLC.All patients were treated with epidermal growth factor receptor(EGFR)for targeted therapy.Before and one month after treatment,CT dynamic contrast-enhanced scan was performed to obtain quantitative parameters,such as perfusion value,peak height(PH),time to peak(Tp).According to status of survival,all patients were divided into the death group(30 cases)and the survival group(86 cases).The relationships between perfusion value,PH,Tp and pathological types,long-term prognosis of targeted therapy were analyzed.Results:Before treatment,there were no significant differences in quantitative parameters of CT dynamic contrast-enhanced scan among patients with different pathological types(all P>0.05).After treatment,perfusion value and PH level decreased,while Tp level increased(all P<0.05).After treatment,perfusion value and PH level in the survival group were even lower than those in the death group,while Tp level was even higher than that in the death group(all P<0.05).ROC curve analysis showed that AUC and cut-off value of perfusion value for predicting long-term prognosis of NSCLC patients were 0.822 and 0.19 mL·min^(-1)·mL^(-1),those of PH were 0.780 and 57.61 HU,and those of Tp were 0.741 and 89.92 s,respectively,and AUC of combined detection was 0.960,which was greater than that of single index(P<0.05).Conclusions:The quantitative parameters of CT dynamic contrast-enhanced scan are not related to pathological types,but are closely related to long-term prognosis of targeted therapy in NSCLC patients.

作者温建安舒进鹏周旭嘉陈涛赵艳玲 WEN Jian’an;SHU Jinpeng;ZHOU Xujia;CHEN Tao;ZHAO Yanling(Department of Imaging,Sinopharm Dongfeng General Hospital,Shiyan 442008,China;Department of Radiology,Taihe Hospital,Shiyan 442008,China)

机构地区国药东风总医院影像科湖北省十堰市太和医院放射科

出处《中国中西医结合影像学杂志》 2024年第4期430-433,共4页 Chinese Imaging Journal of Integrated Traditional and Western Medicine

基金十堰市市级引导性科技项目(22Y84)。

关键词癌非小细胞肺体层摄影术 X线计算机动态增强扫描定量参数病理类型靶向治疗预后 Carcinoma,non-small-cell lung Tomography,X-ray computed Dynamic contrast-enhanced scan Quantitative parameter Pathological type Targeted therapy Prognosis