能谱CT定量参数与肺癌患者病理特征、预后的相关性分析  

Correlation analysis of quantitative parameters of energy spectrum CT with pathological features and prognosis of patients with lung cancer

作　　者：孟锦 张冰凌[1] 孙兴智 李卫星[1] 田晓敏 MENG Jin;ZHANG Bing-ling;SUN Xing-zhi;LI Wei-xing;TIAN Xiao-min(Department of CT,Xinxiang Central Hospital,Xinxiang Henan 453000,China;The Fourth Clinical College of Xinxiang Medical College,Xinxiang Henan 453099,China)

机构地区：[1]新乡市中心医院CT室,河南新乡453000 [2]新乡医学院第四临床学院,河南新乡453099

出　　处：《中国临床医学影像杂志》2025年第3期174-178,共5页Journal of China Clinic Medical Imaging

基　　金：河南省医学科技攻关计划项目(LHGJ20230879)。

摘　　要：目的:探讨能谱CT定量参数与肺癌患者病理特征、预后的相关性。方法:选取2019年9月-2022年6月于我院经病理学检查确诊的102例肺癌患者作为研究组,同期110例肺炎患者作为对照组。所有入组病例均行能谱CT增强扫描,测量能谱CT定量参数(包括能谱曲线斜率(s-SHC)、动脉期标准化碘浓度(NICAP)、静脉期标准化碘浓度(NICVP))。采用受试者工作特性(ROC)曲线评估能谱CT定量参数对肺癌患者预后的预测价值,采用多因素Cox回归分析肺癌患者预后的相关因素。结果:研究组能谱CT定量参数NICAP、NICVP、s-SHC均高于对照组(P<0.05)。腺癌、淋巴转移、T3~T4期浸润深度肺癌患者能谱CT定量参数NICAP、NICVP、s-SHC均高于鳞癌、无淋巴转移、T1~T2期浸润深度肺癌患者(P<0.05)。T1~T2期、T3~T4期肺癌患者2年预后不良例数分别为10例(16.67%)、24例(57.14%),组间比较差异有统计学意义(t=18.214,P<0.05)。2年预后不良肺癌患者能谱CT定量参数NICAP、NICVP、s-SHC均高于2年预后良好肺癌患者(P<0.05)。ROC曲线分析显示,NICAP、NICVP、s-SHC及联合预测肺癌患者2年预后不良的AUC分别为0.830(95%CI:0.780~0.880)、0.845(95%CI:0.795~0.895)、0.866(95%CI:0.816~0.916)、0.911(95%CI:0.861~0.961)。多因素分析显示,淋巴转移(HR=2.098)、T3~T4期浸润深度(HR=2.707)、NICAP≥0.25(HR=3.080)、NICVP≥0.52(HR=4.267)、s-SHC≥1.74(HR=3.611)均为影响肺癌患者2年预后不良的危险因素(P<0.05)。结论:能谱CT定量参数NICAP、NICVP、s-SHC在肺癌患者中升高,且与病理特征、预后密切相关,其对肺癌患者预后具有良好的预测效能。Objective:To explore the correlation between quantitative parameters of energy spectrum CT and pathological features and prognosis of patients with lung cancer.Methods:A total of 102 patients with lung cancer pathologically confirmed at our hospital from September 2019 to June 2022 were selected as the study group,and 110 patients with pneumonia were selected as the control group.All enrolled patients underwent energy spectrum CT enhanced scanning,and quantitative parameters of energy spectrum CT were measured(including energy spectrum curve slope(s-SHC),standardized iodine concentration in arterial phase(NICAP),standardized iodine concentration in venous phase(NICVP)).The predictive value of quantitative parameters of energy spectrum CT on prognosis of patients with lung cancer was evaluated by ROC.The related factors affecting prognosis of lung cancer patients were analyzed by multi-factor Cox regression.Results:The quantitative parameters NICAP,NICVP and s-SHC of energy spectrum CT in study group were significantly higher compared to the control group(P<0.05).CT quantitative parameters NICAP,NICVP and s-SHC in patients with adenocarcinoma,lymphatic metastasis and T3~T4 infiltration depth lung cancer were higher than those in patients with squamous cell carcinoma,no lymphatic metastasis and T1~T2 infiltration depth lung cancer(P<0.05).There were 10(16.67%)and 24(57.14%)patients with stage T1~T2 and stage T3~T4 lung cancer with adverse prognosis at 2 years,respectively,and the difference between groups was statistically significant(t=18.214,P<0.05).CT quantitative parameters NICAP,NICVP and s-SHC of lung cancer patients in the 2-year poor prognosis were higher than those in the 2-year good prognosis(P<0.05).ROC curve analysis showed that the AUC of NICAP,NICVP,s-SHC and combined prediction of 2-year poor prognosis of lung cancer patients were 0.830(95%CI:0.780~0.880),0.845(95%CI:0.795~0.895),0.866(95%CI:0.795~0.895)and 0.911(95%CI:0.861~0.961).A multi-factor analysis showed that lymphatic metastasis(HR=2.098),T3

关 键 词：肺肿瘤 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]