双源计算机断层扫描在肺癌病理类型及临床分期中的应用价值  

Clinical application of dual-source computed tomography in pathological typing and clinical staging of lung cancer

作　　者：杜军华[1] 乔洪源[1] 曹劲松[2] DU Junhua;QIAO Hongyuan;CAO Jingsong(Department of Tumor Radiotherapy and Chemotherapy,the Second People’s Hospital of Three Gorges University,Yichang 443000,Hubei,China;Department of Radiology,the Second People’s Hospital of Three Gorges University,Yichang 443000,Hubei,China)

机构地区：[1]三峡大学第二人民医院肿瘤放化疗科,湖北宜昌4430000 [2]三峡大学第二人民医院放射科,湖北宜昌4430000

出　　处：《癌症进展》2020年第5期463-466,共4页Oncology Progress

基　　金：宜昌市医疗卫生科研项目(A17-301-18)。

摘　　要：目的双源CT在肺癌病理类型及临床分期中的应用价值。方法对86例肺癌患者行双源CT检查,依据病理类型分为腺癌组和鳞状细胞癌组,比较两组患者主动脉达峰时及达峰后第40、60、100秒的净增CT值;依据第8版国际肺癌TNM分期标准,比较不同TNM分期(Ⅰ期13例,Ⅱ期26例,Ⅲ期34例,Ⅳ期13例)患者的标准化碘浓度(NIC)。以受试者工作特征(ROC)曲线及曲线下面积(AUC)分析NIC对肺癌TNM分期的诊断效能。结果腺癌组患者在主动脉达峰时及达峰后第100秒的净增CT值均高于鳞状细胞癌患者,差异均有统计学意义(P﹤0.05);达峰后第40、60秒,两组患者净增CT值比较,差异均无统计学意义(P﹥0.05)。随TNM分期的增加,肺癌患者的NIC值随之增加,差异有统计学意义(P﹤0.05),其中Ⅲ、Ⅳ期肺癌患者的NIC值均高于Ⅰ、Ⅱ期患者,差异均有统计学意义(P﹤0.05)。NIC诊断肺癌TNM分期的AUC为0.925(95%CI:0.855~0.995),灵敏度为86.1%,特异度为88.6%,最佳截断值为0.425。结论双源CT定量参数能间接反映肿瘤的病理类型,在肺腺癌和鳞状细胞癌及临床分期的诊断中发挥重要作用。Objective To explore the clinical application of dual-source CT in the pathological typing and clinical staging of lung cancer. Method The dual-source CT examination were performed in 86 patients with lung cancer, who were further subclassified into adenocarcinoma group or squamous cell carcinoma(SCC) group according to respective pathological types, and the net increased CT values at the time of peak aortic enhancement and at the following 40 s, 60 s,and 100 s after time to peak were compared between the two groups. According to international TNM classification for lung cancer(8 thedition), these lung cancer patients were classified as with different TNM stages(13 cases of stage Ⅰ, 26 cases of stage Ⅱ, 34 cases of stage Ⅲ, and 13 cases of stage Ⅳ), besides, the standardized iodine concentrations(NIC) of patients in each subgroup were compared. The receiver operating characteristic(ROC) curve and the area under the ROC curve(AUC) were used to determine the diagnostic efficiency of NIC for the TNM stage of lung cancer. Result The net increased CT value at the time of peak aortic enhancement and 100 s after time to peak in adenocarcinoma group was higher than that of SCC group, the difference was of statistical significance(P<0.05);while at 40 s and 60 s after time to peak enhancement of the aorta, the net increased CT values in both groups were similar(P>0.05). As the TNM stage increased, the NIC values elevated accordingly and significantly(P<0.05), patients with stage Ⅲ or Ⅳ diseases had significantly higher NIC values compared to those with stage Ⅰ or Ⅱ lesions(P<0.05). The AUC of NIC in diagnosing TNM stating of lung cancer was 0.925(95%CI: 0.855-0.995), demonstrating the diagnostic sensitivity of 86.1%, and the specificity being 88.6%, with the optimal cut-off value at 0.425. Conclusion Quantitative parameters of dual-source CT indirectly reflect the pathological type of lung cancer, representing an important role in the diagnosis of lung adenocarcinoma and squamous cell carcinoma as well as t

关 键 词：双源CT 肺腺癌 肺鳞癌 肺癌分期 

分 类 号：R734.2[医药卫生—肿瘤]