CT灌注参数与NSCLC同步放化疗后肿瘤退缩分级的关系及预测疗效价值  

Relationship Between CT Perfusion Parameters and Tumor Regression Grade After Simultaneous Radiotherapy and Chemotherapy for NSCLC and Their Predictive Value of Efficacy

作　　者：曹伟华 王颖[2] 杜建革 CAO Weihua;WANG Ying;DU Jiange(Department of Radiology,Shaanxi Traffic Hospital;International Medical Center,The First Affiliated Hospital of Xi'an Jiaotong University)

机构地区：[1]陕西省交通医院影像科 [2]西安交通大学第一附属医院健苑五病区·涉外病房

出　　处：《中国医学计算机成像杂志》2023年第2期207-212,共6页Chinese Computed Medical Imaging

摘　　要：目的:探究CT灌注参数与晚期非小细胞肺癌(NSCLC)患者同步放化疗后肿瘤退缩率的关系及其预测疗效价值。方法:选取我院收治的晚期NSCLC患者118例,入院时均行CT灌注检查,均给予同步放化疗,根据疗效分为有效组(67例)与无效组(51例),比较2组CT灌注参数[表面透过性(PS)、血流量(BF)、血容量(BV)]、肿瘤退缩率,分析CT灌注参数与肿瘤退缩率及疗效的关系,并评价CT灌注参数对疗效的预测价值。结果:无效组肺腺癌比例、临床分期高于有效组,肿瘤退缩率、PS、BF、BV低于有效组(P<0.05)。PS、BF、BV与肿瘤分化程度、临床分期显著相关(P<0.05)。Pearson相关性分析显示,PS、BF、BV与肿瘤退缩率呈正相关(P<0.05)。Logistic回归分析表明,PS、BF、BV与晚期肺癌患者同步放化疗的疗效显著相关(P<0.05)。受试者工作特征(ROC)曲线分析显示,PS、BF、BV联合预测疗效的ROC曲线下面积为0.915 (95%CI 0.849~0.958),明显优于三者单独预测。结论:CT灌注参数PS、BF、BV与晚期NSCLC患者同步放化疗后肿瘤退缩率具有正相关关系,三者联合预测疗效价值可靠,可作为临床早期预测疗效的重要途径。Purpose:To investigate the relationship between CT perfusion parameters and tumor regression rate after simultaneous radiotherapy and chemotherapy in patients with advanced non-small cell lung cancer(NSCLC)and to evaluate their predictive value of efficacy.Methods:A total of 118 patients with advanced NSCLC from October 2018 to October 2020 in our hospital were selected as the research objects.CT perfusion examinations were performed upon admission,and concurrent radiotherapy and chemotherapy were given.According to the efficacy,patients were divided into effective group(67 cases)and ineffective group(51 cases).The CT perfusion parameters,including surface permeability(PS),blood flow(BF),blood volume(BV),and tumor shrinkage rate between the two groups were compared.The relationship between CT perfusion parameters and tumor shrinkage rate were analyzed,and the predictive value of CT perfusion parameters for the efficacy was evaluated.Results:The proportion and clinical stage of lung adenocarcinoma in the ineffective group were higher than those in the effective group,and the tumor regression rate,PS,BF,and BV in the ineffective group were lower than those in the effective group(all P<0.05).PS,BF,BV were significantly related to the degree of differentiation and clinical stage(P<0.05).Pearson correlation analysis showed that PS,BF,BV were positively correlated with tumor shrinkage rate(P<0.05).Logistic regression analysis showed that PS,BF,BV were significantly related to the efficacy of concurrent radiotherapy and chemotherapy in patients with advanced NSCLC (P<0.05). Receiver operating characteristic (ROC) curve analysisshowed that the area under the curve of the combination of PS, BF, and BV to predict the efficacy was 0.915 (95%CI0.849-0.958), with the sensitivity and specificity of 78.43% and 94.03%, respectively, which was significantly betterthan those of the three independent predictions.Conclusion: The CT perfusion parameters PS, BF, BV have a positivecorrelation with the tumor shrinkage rate after concurr

关 键 词：晚期肺癌 CT灌注 表面透过性 血流量 血容量 同步放化疗 肿瘤退缩率 疗效 

分 类 号：R811[医药卫生—放射医学]