CT肺密度和肺气肿体积对肺癌患者术后肺功能及肺部并发症的相关性分析  

Correlation between CT lung density and emphysema volume on postoperative lung function and pulmonary complications in lung cancer patients

作　　者：徐志富 张燕妮 沈占贤 王锡丽 XU Zhifu;ZHANG Yanni;SHEN Zhanxian;WANG Xili(Medical Imaging Department,the First Hospital of Zhangjiakou,Zhangjiakou,Hebei 075000,China;Department of Oncology,the First Hospital of Zhangjiakou,Zhangjiakou,Hebei 075000,China;General Internal Medicine Department,Guyuan County People′s Hospital,Zhangjiakou,Hebei 076550,China)

机构地区：[1]张家口市第一医院医学影像科,河北张家口075000 [2]张家口市第一医院肿瘤科,河北张家口075000 [3]固原县人民医院内科,河北张家口076550

出　　处：《临床肺科杂志》2023年第12期1793-1797,共5页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究项目(No.20201599)。

摘　　要：目的探讨CT肺密度和肺气肿体积对肺癌患者术后肺功能及肺部并发症的相关性。方法选取2022年4月至2023年4月手术治疗的肺癌患者77例,术前CT胸部扫描计算肺气肿体积和肺密度,收集术后肺功能参数和肺部并发症情况,分析术前CT参数与术后肺功能和肺部并发症的相关性,ROC曲线检验CT参数预测术后肺部并发症的有效性,Logistic回归分析肺部并发症的影响因素。结果术后FEV_(1)%预测值、D LCO%预测值、FEV_(1)/FVC、MMEF 25%-75%预测值、MEF 50%预测值和D LCO/VA%预测值与术前肺密度成正相关,与术前肺气肿体积成负相关。ROC曲线显示肺密度预测术后肺部并发症的AUC:0.898,临界值:-787.5 HU,敏感度和特异度分别为86.96%和81.48%,肺气肿体积预测肺部并发症的AUC:0.878,临界值:5.41%,敏感度和特异度分别为84.00%和80.00%。Logistic回归显示,术前肺气肿体积>5.41%和肺密度<-787.5HU是术后肺部并发症的独立危险因素。结论术前CT肺密度和肺气肿体积与肺癌患者术后肺功能相关,肺气肿体积>5.41%和肺密度<-787.5 HU是术后肺部并发症的独立危险因素。Objective To explore the correlation between CT lung density and emphysema volume on postoperative lung function and pulmonary complications in lung cancer patients.Methods 77 lung cancer patients who underwent surgical treatment from April 2022 to April 2023 were selected.The preoperative CT chest scan was used to calculate the volume and density of emphysema,collect postoperative lung function parameters and complications,analyze the correlation between preoperative CT parameters and postoperative lung function and complications,test the effectiveness of CT parameters in predicting postoperative lung complications,and analyze the influencing factors of lung complications through logistic regression.Results Postoperative FEV_(1)%predicted value,D LCO%predicted value,FEV_(1)/FVC,MMEF 75-25%predicted value,MEF 50%predicted value and D LCO/VA%predicted value were positively correlated with preoperative lung density,and negatively correlated with preoperative emphysema volume.The ROC curve showed that the AUC of lung density for predicting postoperative pulmonary complications was 0.898,with a critical value of-787.5 HU,sensitivity and specificity of 86.96%and 81.48%,respectively.The AUC of emphysema volume for predicting pulmonary complications was 0.878,with a critical value of 5.41%,sensitivity and specificity of 84.00%and 80.00%,respectively.Logistic regression showed that preoperative emphysema volume>5.41%and lung density<-787.5HU were independent risk factors for postoperative pulmonary complications.Conclusion Preoperative CT lung density and emphysema volume are correlated with postoperative lung function in lung cancer patients.Emphysema volume>5.41%and lung density<-787.5 HU are independent risk factors for postoperative pulmonary complications.

关 键 词：体层摄影术 肺气肿体积 肺密度 肺功能 术后并发症 

分 类 号：R734.2[医药卫生—肿瘤]