三维CT值定量分析在Ⅰ期肺腺癌预后判断中的应用

发布时间：2018-04-12 18:56

本文选题：肺肿瘤 + 腺癌　；参考：《放射学实践》2017年06期

【摘要】：目的:探讨三维CT值定量分析所得磨玻璃(GGO)成分比例和实性成分比例在判断Ⅰ期肺腺癌(3cm)预后中的价值。方法:对2005年1月至2012年12月行手术切除并有随访结果的114例病理Ⅰ期肺腺癌患者的HRCT、临床、病理资料进行回顾性分析。采用三维CT值定量分析软件对病灶GGO成分和实性成分比例进行计算。根据随访结果,按照是否有疾病进展分为进展组和无病生存组,比较两组的临床、病理及影像指标的差异。采用Cox回归对上述指标进行多因素分析,采用受试者工作特征曲线(ROC)确定预测肿瘤进展的临界值,采用Kaplan-Meier法比较不同GGO成分和实性成分比例患者的无进展生存情况。结果:114例Ⅰ期肺腺癌中进展组51例,无病生存组63例,5年无病生存率为55.3%。性别、吸烟状况、病理评分、附壁成分比例、实性成分比例、GGO成份比例、病变类型在两组中的差异具有统计学意义(P≤0.05)。多因素分析显示GGO成分比例(P=0.04)和实性成分比例(P0.01)与预后相关,其界值分别为0.13和0.47。GGO成分比例≥0.13组的无病生存率(26.0%)要明显高于GGO成分比例0.13组(39.1%,P0.01),实性成分比例≥0.47组的无病生存率(33.3%)要明显低于实性成分比例0.47组(82.4%,P0.01)。结论:三维CT值定量分析所得GGO成分比例和实性成分比例对Ⅰ期肺腺癌术后疾病进展有较高预测价值,可以作为预后判断的重要指标。
[Abstract]:Objective: To investigate the value of quantitative analysis of the 3D CT ground glass (GGO) composition and solid composition proportion in judging the stage I lung adenocarcinoma (3cm) prognosis. Methods and follow-up results of resection from January 2005 to December 2012 114 cases surgery pathological stage I lung adenocarcinoma patients with HRCT, clinical. The pathological data were retrospectively analyzed. Using three-dimensional CT quantitative analysis software to calculate the focus of GGO composition and solid composition ratio. According to the follow-up results, according to whether the disease divided into progressive group and disease-free survival group, compared two groups, difference between pathology and imaging indexes. By multivariate Cox regression the analysis of the above indexes, the receiver operating characteristic curve (ROC) to determine the critical value of predicting tumor progression, progression free survival Kaplan-Meier method was used to compare different GGO composition and solid composition proportion of patients. Results: 114 cases 51 cases of advanced lung adenocarcinoma, disease-free survival group 63 cases, 5 year disease free survival rate was 55.3%. gender, smoking status, pathologic score, wall composition ratio, solid component ratio, GGO composition ratio, the difference was statistically significant in two groups of pathological type (P = 0.05). Multivariate analysis showed that GGO component ratio (P=0.04) and solid component ratio (P0.01) is correlated with the prognosis and the value of disease-free survival rate was 0.13 and the proportion of more than 0.13 0.47.GGO group (26%) was significantly higher than that in GGO group (39.1%, 0.13 proportion of P0.01), the solid component than the disease free survival the rate of more than 0.47 cases of group (33.3%) was significantly lower than that of the solid component ratio of 0.47 groups (82.4%, P0.01). Conclusion: the quantitative analysis of the income GGO composition and solid composition ratio have a higher predictive value on stage I lung adenocarcinoma postoperative disease value of 3D CT, can be used as an important indicator of prognosis.

【作者单位】：国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科;国家癌症中心/中国医学科学院北京协和医学院PET-CT中心;北京大学肿瘤医院病理科;国家癌症中心/中国医学科学院北京协和医学院全国肿瘤防治研究办公室;
【基金】：国家自然科学基金项目(81601494) 国家科技支撑计划(2014BAⅠ09B00) 北京市科委重点项目(D141100000214006) 协和青年科研基金(3332016030)
【分类号】：R730.44;R734.2

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