动态对比增强磁共振成像定量参数联合血清SCC-Ag预测肺癌脑转移瘤预后的价值  

Value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters combined with serum SCC-Ag in predicting the prognosis of lung cancer brain metastases

作　　者：徐翠霞 魏俊明 张云萍 崔刚 XU Cuixia;WEI Junming;ZHANG Yunping;CUI Gang(Department of CT-MRI,the Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,China)

机构地区：[1]邢台医专第二附属医院CT-MRI科,河北邢台054000

出　　处：《东南大学学报(医学版)》2025年第2期306-312,共7页Journal of Southeast University(Medical Science Edition)

基　　金：邢台市重点研发计划自筹项目(2023ZC141);河北省卫生健康委科研基金项目(20241818)。

摘　　要：目的:探讨动态对比增强磁共振成像定量参数联合血清鳞状上皮细胞癌抗原(SCC-Ag)预测肺癌脑转移瘤预后的价值。方法:回顾性分析2019年1月至2022年6月我院收治的97例肺癌伴有脑转移瘤患者的临床资料,患者经相关治疗后随访记录1年。根据患者预后情况将97例患者分为良好组(61例)和不良组(36例)。对比良好组与不良组患者血管外细胞外间隙容积比(Ve)、容量转移常数(K trans)、速率常数(Kep)以及血清SCC-Ag水平,采用多因素Logistic回归分析肺癌脑转移瘤患者预后不良的主要影响因素,并且运用ROC曲线分析联合检测对肺癌脑转移瘤预后不良的预测价值。结果:与不良组比较,良好组患者Ve、K trans、Kep以及血清SCC-Ag水平较低(P<0.05);多因素Logistic回归分析显示,脑转移瘤数量≥4个、血清SCC-Ag、有其他部位发生病灶和转移、Kep、脑转移瘤最大直径≥3 cm、Ve、K t rans均是肺癌脑转移瘤患者不良预后的影响因素(P<0.05);ROC曲线显示,与Ve、Kep、K trans、血清SCC-Ag单项检测相比,联合检测的预测价值更高(P<0.05)。结论:动态对比增强磁共振成像定量参数联合血清SCC-Ag对肺癌脑转移瘤患者的不良预后具有一定的预测价值,且脑转移瘤数量≥4个、血清SCC-Ag、有其他部位发生病灶和转移、Kep、脑转移瘤最大直径≥3 cm、Ve、K trans均是预后不良的主要危险因素。Objective:To study the value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters combined with serum squamous cell carcinoma antigen(SCC-Ag)in predicting the prognosis of lung cancer brain metastases.Methods:Clinical data of 97 patients with lung cancer accompanied by brain metastases admitted to our hospital from January 2019 to June 2022 were retrospectively analyzed.After treatment,the follow-up was recorded for 1 year.According to the results of follow-up,97 patients were divided into good group and bad group,61 patients in good group and 36 patients in bad group.The extracellular space volume ratio(Ve),volume transfer constant(K trans),rate constant(Kep)and serum SCC-Ag levels in the good group and the bad group were compared,and the main factors affecting the poor prognosis of lung cancer patients with brain metastases were analyzed by multivariate Logistic regression.The ROC curve analysis was used to predict the poor prognosis of lung cancer brain metastases.Results:Compared with the bad group,the levels of Ve,K trans,Kep and serum SCC-Ag in the good group were lower(P<0.05);Multivariate Logistic regression analysis showed that the number of brain metastases≥4,serum SCC-Ag,lesions and metastases in other sites,Kep,maximum diameter of brain metastases≥3 cm,Ve and K trans were the main factors affecting the adverse prognosis of lung cancer patients with brain metastases(P<0.05).ROC curve showed that combined detection of Ve,Kep,K trans and serum SCC-Ag had higher predictive value than those of single detection(P<0.05).Conclusion:Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging combined with serum SCC-Ag have certain predictive value for poor prognosis of lung cancer brain metastasis patients,and the number of brain metastasis≥4,serum SCC-Ag,lesions and metastasis in other sites,Kep,brain metastasis maximum diameter≥3 cm,Ve,K trans are the main risk factors affecting the poor prognosis of lung cancer patients with brain metastases.

关 键 词：动态对比增强磁共振成像定量参数 鳞状上皮细胞癌抗原 肺癌脑转移瘤 危险因素 联合检测 预测价值 

分 类 号：R739.41[医药卫生—肿瘤]