多层螺旋CT灌注参数联合外周血炎症复合指标对非小细胞肺癌患者纵隔淋巴结转移的预测价值  

Prognostic value of multi-slice spiral CT perfusion parameters combined with peripheral blood inflammatory complex indexes in mediastinal lymph node metastasis in patients with non-small cell lung cancer

作　　者：孙兴智 栗鸿宝 朱思毅 李卫星 SUN Xing-zhi;LI Hong-bao;ZHU Si-yi(Department of CT,Xinxiang Central Hospital/the Fourth Clinical College of Xinxiang Medical University,453000 Henan,China)

机构地区：[1]新乡市中心医院/新乡医学院第四临床学院CT室,河南新乡453000 [2]新乡市人工智能和高级医学影像学技术重点实验室,河南新乡453000

出　　处：《放射学实践》2025年第3期325-330,共6页Radiologic Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230879)。

摘　　要：目的:探讨多层螺旋CT(MSCT)灌注参数联合外周血炎症复合指标对非小细胞肺癌(NSCLC)患者纵隔淋巴结转移的预测价值。方法:选择2022年1月-2024年6月于本院接受手术治疗和术中淋巴结清扫的140例NSCLC患者作为研究对象。术前所有患者均在GE Revolution 256CT上进行MSCT检查,记录MSCT灌注参数,包括病灶区域的血流量(BF)、平均通过时间(MTT)、血容量(BV)以及表面通透性(PS)。收集所有患者的性别、年龄、病理类型、肿瘤部位分布、肿瘤大叶分布、肿瘤类型、肿瘤直径和肿瘤同侧纵隔淋巴结短直径。收集患者术前血常规中的红细胞分布宽度(RDW)、血红蛋白计数(Hb)、中性粒细胞计数(N)、淋巴细胞计数(L)、血小板计数(P)、单核细胞计数(M),计算中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、淋巴细胞与单核细胞比值及血红蛋白与红细胞分布宽度比值。结果:与未转移组患者比较,转移组患者的肿瘤直径和肿瘤同侧纵隔淋巴结短直径显著增加,BF、BV、PS、NLR和PLR显著增加,LMR和HRR均显著降低,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,较大的BF、BV、PS、NLR和PLR是NSCLC患者发生纵隔淋巴结转移的独立危险因素(P<0.05)。BF、BV、PS、NLR和PLR单独及联合预测NSCLC患者纵隔淋巴结转移的敏感度和特异度分别为88.9%和70.9%、83.3%和72.1%、64.8%和83.7%、74.1%和77.9%、70.4%和67.4%、94.4%和83.7%。结论:MSCT灌注参数联合外周血炎症复合指标对NSCLC患者纵隔淋巴结转移的预测效能较好,具有一定临床应用价值。Objective:To explore the predictive value of multi-slice spiral CT(MSCT)perfusion parameters combined with peripheral blood inflammatory composite indicators for mediastinal lymph node metastasis in patients with non-small cell lung cancer(NSCLC).Methods:A total of 140 patients with NSCLC who underwent surgical treatment and intraoperative lymph node dissection in our hospital from January 2022 to June 2024 were selected as the research subjects.All patients underwent MSCT examination on GE Revolusion 256 CT before surgery.The MSCT perfusion parameters were recorded,including blood flow(BF),mean transit time(MTT),blood volume(BV),and permeability surface(PS)in the lesion area.The gender,age,pathological type,tumor location,distributionof tomor lobes,tumor type,tumor diameter,and short diameter of the ipsilateral mediastinal lymph nodes of all patients were collected.The red blood cell distribution width(RDW),hemoglobin count(Hb),neutrophil count(N),lymphocyte count(L),platelet count(P),and monocyte count(M)in the preoperative blood routine of the patients were collected.The neutrophil-tolymphocyte ratio,platelet-to-lymphocyte ratio,lymphocyte-to-monocyte ratio and hemoglobin-to-red blood cell distribution width ratio were calculated.Results:Compared with the patients in the non-metastasis group,the tumor diameter and the short diameter of the ipsilateral mediastinal lymph nodes in the metastasis group were significantly increased.BF,BV,PS,NLR and PLR were significantly increased,while LMR and HRR were significantly decreased,and the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that larger BF,BV,PS,NLR and PLR were independent risk factors for mediastinal lymph node metastasis in NSCLC patients(P<0.05).The sensitivity and specificity of BF,BV,PS,NLR and PLR alone and in combination for predicting mediastinal lymph node metastasis in NSCLC patients were 88.9%and 70.9%,83.3%and 72.1%,64.8%and 83.7%,74.1%and 77.9%,70.4%and 67.4%,94.4%and 83.7%,resp

关 键 词：肺肿瘤 非小细胞肺癌 体层摄影术 X线计算机 外周血炎症复合指标 纵隔淋巴结转移 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]