原发性肺鳞癌与肺腺癌临床特点的对比及两者原发灶SUVmax与肿瘤大小及TNM分期的相关性研究
发布时间：2018-08-09 14:14
【摘要】：目的:分析原发性肺鳞癌与肺腺癌在临床症状、血清肿瘤标志物、血液高凝状态相关指标、影像学特征、PET/CT(Positron Emission Computed Tomography/Computed Tomography,正电子发射断层显像/X射线断层扫描技术)表现等方面的差异,探讨肺鳞癌与肺腺癌临床特点的差异,并分别对肺鳞癌及肺腺癌原发灶SUVmax(Maximum standard uptake value,最大标准摄取值)与肿瘤大小及其TNM分期进行相关性分析。方法:回顾性分析西南医科大学附属医院2013年1月-2016年5月期间考虑为肺癌收入院的患者,通过手术、可弯曲支气管镜、内科胸腔镜、经皮肺穿刺、淋巴结穿刺等方法取得的组织学或细胞学标本,经病理检查及免疫组化确诊为原发性非小细胞肺癌的患者,并完善PET/CT检查者,按病理类型将其分为肺鳞癌及肺腺癌两组,分析比较两种不同病理类型肺癌患者的性别、年龄、吸烟与否、临床症状(咳嗽、胸痛、咯血、呼吸困难、发热、体重下降等)、血清肿瘤标志物CEA(Carcino-embryonic antigen,癌胚抗原)、NSE(Neuron-specific enolase,神经元特异性烯醇化酶)、CA125(Carbohydrate antigen 125,糖类抗原125)、SCCA(Squamous cell carcinoma antigen,鳞状细胞癌相关抗原)及CYFRA-21-1(Cytokeratin 19 fragment,细胞角蛋白19片段)、血液高凝状态指标D-二聚体、Fib(Fibrinogen,血浆纤维蛋白原)、血小板计数、原发病灶胸部CT的影像学特点(有无分叶征、毛刺征、胸膜牵拉征、肺不张、支气管狭窄、阻塞性肺炎等)、原发灶大小、PET/CT中SUVmax值大小等方面的差异;对肺鳞癌组及肺腺癌组原发灶SUVmax与其肿瘤病灶大小作相关性分析,并按原发灶大小分别将肺鳞癌及肺腺癌组分为三个亚组(原发灶直径≤3cm亚组、3cm且≤7cm亚组、7cm亚组),分析三个亚组间原发灶SUVmax之间的差异,分别将肺鳞癌及肺腺癌原发灶SUVmax与TNM分期作相关性分析。结果:1.一般情况:纳入病例总数259例,其中肺鳞癌组116例,肺腺癌组143例;肺腺癌组的性别百分比分别是男51.7%(74例)、女48.3%(69例),肺鳞癌组的性别比例为男94.0%(109例),女6.0%(7例),两组间的性别构成差异具有统计学意义(P0.05);肺腺癌组中最小年龄29岁,最大年龄80岁,平均年龄(57.2±11.0)岁,肺鳞癌组中最小年龄37岁,最大年龄83岁,平均年龄(58.4±9.4)岁,两组间年龄构成比无明显差异;肺鳞癌组的吸烟患者数101例(87.1%)、肺腺癌组吸烟患者数58例(40.5%),肺鳞癌组吸烟率高于肺腺癌组(P0.05)。2.临床症状:肺鳞癌组中咳嗽99例(85.3%)、咯血50例(43.1%)、呼吸困难53例(45.7%)、体重下降例49(42.2%),肺腺癌组中咳嗽103例(72.0%)、咯血35例(24.5%)、呼吸困难37例(25.9%)、体重下降例41(28.7%),肺鳞癌组中临床症状(咳嗽、咯血、呼吸困难、体重下降)占比高于肺腺癌组,差异具有统计学意义(P0.05)。3.血清肿瘤标志物:肺鳞癌组患者血清肿瘤标志物的含量为:CEA(9.16±18.35)ng/ml、NSE(11.91±10.39)ng/ml、CA125(48.78±108.24)IU/ml、SCCA(11.18±30.57)IU/ml、CYFRA-21-1(9.23±15.25)ng/ml,肺腺癌组患者血清肿瘤标志物的含量为:CEA(24.27±36.37)ng/ml、NSE(10.61±9.08)ng/ml、CA125(140.09±250.65)IU/ml、SCCA(1.29±2.86)IU/ml、CYFRA-21-1(6.16±14.71)ng/ml,在上述血清肿瘤标志物中肺腺癌组患者血清的CEA及CA125含量高于肺鳞癌组、SCCA及CYFRA-21-1的含量低于肺鳞癌组,且差异有统计学意义(P0.05)。4.血液高凝状态相关指标:肺腺癌组患者血液中D-二聚体含量为(1.66±2.51)ug/ml,高于肺鳞癌组患者(0.59±0.49)ug/ml,差异具有统计学意义(P0.05);血小板含量在肺鳞癌组及肺腺癌组患者间无明显差异(P0.05),分别为(297.36±93.21)×109/L、(288.46±89.56)×109/L;肺鳞癌及肺腺癌的Fib(血浆纤维蛋白原)含量亦无明显差异,分别为(4.32±1.28)g/L、(4.47±1.42)g/L(P0.05)。5.影像学方面:肺鳞癌组中原发灶存在分叶征者有67例(57.8%)、毛刺征20例(17.2%)、胸膜牵拉征40例(34.5%)、阻塞性肺不张41例(35.3%)、阻塞性肺炎39例(33.6%)、空泡征12例(10.3%)、气管腔狭窄57例(49.1%),肺腺癌组中原发灶具有分叶征者88例(61.5%)、毛刺征32例(22.4%)、胸膜牵拉征82例(57.3%)、阻塞性肺不张18例(12.6%)、阻塞性肺炎17例(11.9%)、空泡征15例(10.5%)、气管腔狭窄阻塞36例(25.2%),其中肺鳞癌组原发灶具有阻塞性肺不张、阻塞性肺炎、气管腔狭窄征象的比例高于肺腺癌组,具有胸膜牵拉征象的比例低于肺腺癌组,差异具有统计学意义(P0.05);肺鳞癌组原发灶直径为(5.15±2.40)cm,大于肺腺癌组原发灶直径(3.73±2.10)cm,差异具有统计学意义(P0.05);肺鳞癌原发灶SUVmax值为(13.22±4.92),高于肺腺癌(8.94±4.06)(P0.05),但在不同原发灶大小三亚组间,仅当病灶直径≤3cm时,肺鳞癌原发灶SUVmax较肺腺癌大。6.在相关性分析中:肺鳞癌组原发灶SUVmax与其原发灶大小呈显著正相关,其相关系数为0.31(P=0.008),肺腺癌组原发灶SUVmax与其原发灶大小亦呈显著正相关,其相关系数0.41(P=0.000);肺鳞癌原发灶SUVmax与T分期的显著相关,相关系数为0.324(P=0.005)、与N分期及M分期无明显相关,其相关系数分别为0.066(P=0.581)、0.046(P=0.699);肺腺癌的原发灶SUVmax与T分期的相关系数为0.479(P=0.000)、与N分期的相关系数为0.268(P=0.011)、与M分期的相关系数为0.262(P=0.013)其原发灶SUVmax与T分期、N分期、M分期均相关。结论:1.肺鳞癌患者中男性比例及吸烟率高于肺腺癌患者,肺鳞癌与肺腺癌患者年龄构成无明显差异;2.肺鳞癌患者临床症状(咳嗽、咯血、呼吸困难、体重下降)的发生率高于肺腺癌患者;3.肺腺癌患者血清CEA及CA125含量高于肺鳞癌患者,SCCA及CYFRA-21-1的含量低于肺鳞癌患者;4.肺腺癌患者血清中D-二聚体可能高于肺鳞癌患者,肺腺癌及肺鳞癌患者血液中的血小板含量及Fib浓度无明显差异;5.肺鳞癌患者胸部CT表现为阻塞性肺不张、阻塞性肺炎、气管腔狭窄的比例高于肺腺癌患者,肺腺癌患者胸膜牵拉征比例高于肺鳞癌患者;肺鳞癌患者原发灶大小高于肺腺癌患者,当原发灶直径≤3cm时,肺鳞癌患者原发灶SUVmax值高于肺腺癌患者;6.肺鳞癌组与肺腺癌组SUVmax高低均与原发灶大小显著正相关,均表现为原发灶直径越大,其SUVmax值越高;肺鳞癌组SUVmax高低与T分期显著相关,前者越高,T分期越高,但其与N分期、M分期无明显相关;肺腺癌组SUVmax高低与T分期、N分期、M分期均显著相关,SUVmax越高,分期越晚。
[Abstract]:Objective: to analyze the clinical symptoms of primary lung squamous cell carcinoma and lung adenocarcinoma in clinical symptoms, serum tumor markers, blood hypercoagulable state, imaging features, PET/CT (Positron Emission Computed Tomography/Computed Tomography, /X ray tomography of positron emission tomography), and to explore lung squamous cell carcinoma and lung adenocarcinoma. The difference in clinical characteristics, and the correlation analysis of SUVmax (Maximum standard uptake value, maximum standard intake) and tumor size and TNM staging of the primary lung cancer and lung adenocarcinoma. Methods: a retrospective analysis was carried out in the Affiliated Hospital of Southwest Medical University in May January 2013, which was considered as a lung cancer income hospital. Surgery, bendable bronchoscopy, internal medical thoracoscopy, percutaneous lung puncture, lymph node puncture and other histological or cytological specimens, confirmed by pathological examination and immunohistochemistry, were diagnosed as primary non-small cell lung cancer and were perfected by PET/CT, divided into two groups of lung squamous cell carcinoma and lung adenocarcinoma according to pathological types, analysis and comparison of two different types. Sex, age, smoking or not, clinical symptoms (coughing, chest pain, hemoptysis, dyspnea, fever, weight loss, etc.), serum tumor markers CEA (Carcino-embryonic antigen, carcinoembryonic antigen), NSE (Neuron-specific enolase, deity specific enolase), CA125 (Carbohydrate antigen 125, saccharide antigen 125), S, S, and S, S. CCA (Squamous cell carcinoma antigen, squamous cell carcinoma associated antigen) and CYFRA-21-1 (Cytokeratin 19 fragment, cytokeratin 19 fragment), blood hypercoagulable state index D- two polymer, Fib (Fibrinogen, plasma fibrinogen), platelet count, the imaging characteristics of the primary focus of the chest CT (without lobular sign, burr sign, pleural stretch sign, Pulmonary atelectasis, bronchostenosis, obstructive pneumonia, etc., the size of primary foci and the size of SUVmax in PET/CT; the correlation between the primary SUVmax and the tumor size of the lung squamous cell carcinoma group and the lung adenocarcinoma group was analyzed, and the lung squamous cell carcinoma and the lung adenocarcinoma group were divided into three subgroups according to the size of the primary foci (primary diameter less than 3cm subgroup, 3cm The difference between the primary foci of the three subgroups and the difference between the primary SUVmax of the three subgroups was analyzed, and the correlation between the SUVmax and the TNM staging of the lung squamous cell carcinoma and the lung adenocarcinoma was analyzed. Results: 1. general cases were included in 259 cases, including 116 cases of lung squamous cell carcinoma, 143 cases of lung adenocarcinoma group, and 51.7% of the sex of lung adenocarcinoma group (74 cases). Female 48.3% (69 cases), the sex ratio of the lung squamous cell carcinoma group was 94% (109 cases) and 6% (7). The difference between the two groups was statistically significant (P0.05). The minimum age of the lung adenocarcinoma group was 29 years old, the maximum age was 80 years, the average age was (57.2 + 11) years, the minimum age of the lung squamous cell carcinoma was 37 years, the maximum age was 83 years, the average age (58.4 + 7) years old. There were no significant differences in the age composition ratio among the groups; the number of smokers in the lung squamous cell carcinoma group was 101 (87.1%), the number of smoking patients in the lung adenocarcinoma group was 58 (40.5%). The smoking rate of the lung squamous cell carcinoma group was higher than that of the lung adenocarcinoma group (P0.05).2. clinical symptoms: 99 cases of coughing in the lung squamous cell carcinoma group (85.3%), 50 cases of hemoptysis (43.1%), 53 cases of dyspnea (45.7%), weight decline case 49 (42.2%), lung adenocarcinoma group There were 103 cases of coughing (72%), 35 cases of hemoptysis (24.5%), 37 cases of dyspnea (25.9%), and 41 (28.7%) of weight loss. The ratio of clinical symptoms (coughing, hemoptysis, dyspnea, weight loss) in the lung squamous cell carcinoma group was higher than that in the lung adenocarcinoma group, and the difference was statistically significant (P0.05).3. serum tumor markers: the serum tumor markers in the lung squamous cell carcinoma group were CEA (9.16 + 18.35) ng/ml, NSE (11.91 + 10.39) ng/ml, CA125 (48.78 + 108.24) IU/ml, SCCA (11.18 + 30.57) IU/ml, CYFRA-21-1 (9.23 + 15.25) ng/ml. The content of the serum tumor markers in the lung adenocarcinoma group was CEA (24.27 + 36.37) ng/ml. The serum levels of CEA and CA125 in the lung adenocarcinoma group were higher than those in the lung squamous cell carcinoma group, and the content of SCCA and CYFRA-21-1 was lower than that of the lung squamous cell carcinoma group, and the difference was statistically significant (P0.05).4. blood hypercoagulable state related index: the content of D- two polymer in the blood of the lung adenocarcinoma group was (1.66 + 2.51) ug/ml, higher than that of the lung squamous cell carcinoma group (0.5 9 + 0.49) ug/ml, the difference was statistically significant (P0.05); there was no significant difference in the platelet content between the lung squamous cell carcinoma group and the lung adenocarcinoma group (P0.05), respectively (297.36 + 93.21) x 109/L, (288.46 + 89.56) x 109/L, and there was no significant difference between the lung squamous cell carcinoma and the lung adenocarcinoma (4.32 + 1.28) g/L, (4.47 + 1.42) g/L (P0), respectively. .05).5. imaging: there were 67 cases (57.8%), 20 cases of burr sign (17.2%), 40 cases of pleural stretch sign (34.5%), 41 cases of obstructive pulmonary atelectasis (35.3%), 39 obstructive pulmonary disease (33.6%), 12 cases of obstructive pulmonary disease (10.3%), pneumonoid stenosis in 57 cases (33.6%), and lobular syndrome in the lung adenocarcinoma group, and hair in the lung adenocarcinoma group. 32 cases (22.4%), 82 cases (57.3%) of pleural stretch sign, 18 cases of obstructive pulmonary atelectasis (12.6%), 17 cases of obstructive pneumonia (11.9%), 15 cases of vacuoles syndrome (10.5%) and 36 cases of tracheal stenosis obstruction (25.2%), of which the primary foci in the lung squamous cell carcinoma group were obstructive pulmonary atelectasis, obstructive pneumonia, and the proportion of tracheal stenosis was higher than that of lung adenocarcinoma group, with pleural traction. The proportion of the signs was lower than that in the lung adenocarcinoma group (P0.05), the primary focal diameter of the lung squamous cell carcinoma group was (5.15 + 2.40) cm, which was greater than that of the lung adenocarcinoma group (3.73 + 2.10) cm, and the difference was statistically significant (P0.05). The SUVmax value of the lung squamous cell carcinoma was (13.22 + 4.92), higher than that of lung adenocarcinoma (8.94 + 4.06) (P0.05), but in different primary foci Between the size and size of the Sanya group, when the lesion diameter was less than 3cm, the primary SUVmax of the lung squamous cell carcinoma was compared with the large.6. of the lung adenocarcinoma. The primary focus of SUVmax in the lung squamous cell carcinoma group was significantly positively correlated with the size of the primary foci, and the correlation coefficient was 0.31 (P=0.008). The primary focal size of the lung adenocarcinoma group was also positively correlated with the size of the primary focal lesion, and the correlation coefficient was 0.41. (P=0.000): the correlation coefficient of SUVmax and T staging was 0.324 (P=0.005), and the correlation coefficient was 0.066 (P=0.581) and 0.046 (P=0.699), respectively. The correlation coefficient between SUVmax and T staging of lung adenocarcinoma was 0.479 (P=0.000), and the correlation coefficient with N stage was 0.268. The correlation coefficient of the staging was 0.262 (P=0.013) SUVmax and T staging, N staging and M staging. Conclusion: the male proportion and smoking rate in 1. lung squamous cell carcinoma patients were higher than those of lung adenocarcinoma, and there was no significant difference in age composition between lung squamous cell carcinoma and lung adenocarcinoma patients; 2. patients with lung squamous cell carcinoma were associated with bed symptoms (cough, hemoptysis, dyspnea, weight loss). The levels of serum CEA and CA125 in 3. patients with lung adenocarcinoma were higher than those of lung squamous cell carcinoma, and the content of SCCA and CYFRA-21-1 was lower than that of lung squamous cell carcinoma. The serum D- two polymer in the serum of 4. lung adenocarcinoma patients may be higher than that of lung squamous cell carcinoma, and the blood small plate content and Fib concentration in the blood of the lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference; 5. lung squamous cell carcinoma patients The proportion of CT in the chest was obstructive pulmonary atelectasis, obstructive pneumonia, and the proportion of tracheal stenosis was higher than that of lung adenocarcinoma. The proportion of pleural traction in lung adenocarcinoma patients was higher than that of lung squamous cell carcinoma; the primary focal size of lung squamous cell carcinoma was higher than that of lung adenocarcinoma. When the primary diameter was less than 3cm, the SUVmax value of the primary lung cancer patients was higher than that of the lung adenocarcinoma patients; 6. lung squamous cell scale was higher than that of the lung adenocarcinoma. The high and low levels of SUVmax in the cancer group and the lung adenocarcinoma group were significantly correlated with the size of the primary focus, the higher the diameter of the primary focus, the higher the SUVmax value. The higher the SUVmax level in the lung squamous cell carcinoma group was associated with the T staging. The higher the former, the higher the T stage, but it was not associated with the N staging, M staging, and the level of SUVmax in the lung adenocarcinoma group was significantly different from the T staging, N staging, M staging. The higher the SUVmax, the later the stages are.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2
本文编号：2174334
[Abstract]:Objective: to analyze the clinical symptoms of primary lung squamous cell carcinoma and lung adenocarcinoma in clinical symptoms, serum tumor markers, blood hypercoagulable state, imaging features, PET/CT (Positron Emission Computed Tomography/Computed Tomography, /X ray tomography of positron emission tomography), and to explore lung squamous cell carcinoma and lung adenocarcinoma. The difference in clinical characteristics, and the correlation analysis of SUVmax (Maximum standard uptake value, maximum standard intake) and tumor size and TNM staging of the primary lung cancer and lung adenocarcinoma. Methods: a retrospective analysis was carried out in the Affiliated Hospital of Southwest Medical University in May January 2013, which was considered as a lung cancer income hospital. Surgery, bendable bronchoscopy, internal medical thoracoscopy, percutaneous lung puncture, lymph node puncture and other histological or cytological specimens, confirmed by pathological examination and immunohistochemistry, were diagnosed as primary non-small cell lung cancer and were perfected by PET/CT, divided into two groups of lung squamous cell carcinoma and lung adenocarcinoma according to pathological types, analysis and comparison of two different types. Sex, age, smoking or not, clinical symptoms (coughing, chest pain, hemoptysis, dyspnea, fever, weight loss, etc.), serum tumor markers CEA (Carcino-embryonic antigen, carcinoembryonic antigen), NSE (Neuron-specific enolase, deity specific enolase), CA125 (Carbohydrate antigen 125, saccharide antigen 125), S, S, and S, S. CCA (Squamous cell carcinoma antigen, squamous cell carcinoma associated antigen) and CYFRA-21-1 (Cytokeratin 19 fragment, cytokeratin 19 fragment), blood hypercoagulable state index D- two polymer, Fib (Fibrinogen, plasma fibrinogen), platelet count, the imaging characteristics of the primary focus of the chest CT (without lobular sign, burr sign, pleural stretch sign, Pulmonary atelectasis, bronchostenosis, obstructive pneumonia, etc., the size of primary foci and the size of SUVmax in PET/CT; the correlation between the primary SUVmax and the tumor size of the lung squamous cell carcinoma group and the lung adenocarcinoma group was analyzed, and the lung squamous cell carcinoma and the lung adenocarcinoma group were divided into three subgroups according to the size of the primary foci (primary diameter less than 3cm subgroup, 3cm The difference between the primary foci of the three subgroups and the difference between the primary SUVmax of the three subgroups was analyzed, and the correlation between the SUVmax and the TNM staging of the lung squamous cell carcinoma and the lung adenocarcinoma was analyzed. Results: 1. general cases were included in 259 cases, including 116 cases of lung squamous cell carcinoma, 143 cases of lung adenocarcinoma group, and 51.7% of the sex of lung adenocarcinoma group (74 cases). Female 48.3% (69 cases), the sex ratio of the lung squamous cell carcinoma group was 94% (109 cases) and 6% (7). The difference between the two groups was statistically significant (P0.05). The minimum age of the lung adenocarcinoma group was 29 years old, the maximum age was 80 years, the average age was (57.2 + 11) years, the minimum age of the lung squamous cell carcinoma was 37 years, the maximum age was 83 years, the average age (58.4 + 7) years old. There were no significant differences in the age composition ratio among the groups; the number of smokers in the lung squamous cell carcinoma group was 101 (87.1%), the number of smoking patients in the lung adenocarcinoma group was 58 (40.5%). The smoking rate of the lung squamous cell carcinoma group was higher than that of the lung adenocarcinoma group (P0.05).2. clinical symptoms: 99 cases of coughing in the lung squamous cell carcinoma group (85.3%), 50 cases of hemoptysis (43.1%), 53 cases of dyspnea (45.7%), weight decline case 49 (42.2%), lung adenocarcinoma group There were 103 cases of coughing (72%), 35 cases of hemoptysis (24.5%), 37 cases of dyspnea (25.9%), and 41 (28.7%) of weight loss. The ratio of clinical symptoms (coughing, hemoptysis, dyspnea, weight loss) in the lung squamous cell carcinoma group was higher than that in the lung adenocarcinoma group, and the difference was statistically significant (P0.05).3. serum tumor markers: the serum tumor markers in the lung squamous cell carcinoma group were CEA (9.16 + 18.35) ng/ml, NSE (11.91 + 10.39) ng/ml, CA125 (48.78 + 108.24) IU/ml, SCCA (11.18 + 30.57) IU/ml, CYFRA-21-1 (9.23 + 15.25) ng/ml. The content of the serum tumor markers in the lung adenocarcinoma group was CEA (24.27 + 36.37) ng/ml. The serum levels of CEA and CA125 in the lung adenocarcinoma group were higher than those in the lung squamous cell carcinoma group, and the content of SCCA and CYFRA-21-1 was lower than that of the lung squamous cell carcinoma group, and the difference was statistically significant (P0.05).4. blood hypercoagulable state related index: the content of D- two polymer in the blood of the lung adenocarcinoma group was (1.66 + 2.51) ug/ml, higher than that of the lung squamous cell carcinoma group (0.5 9 + 0.49) ug/ml, the difference was statistically significant (P0.05); there was no significant difference in the platelet content between the lung squamous cell carcinoma group and the lung adenocarcinoma group (P0.05), respectively (297.36 + 93.21) x 109/L, (288.46 + 89.56) x 109/L, and there was no significant difference between the lung squamous cell carcinoma and the lung adenocarcinoma (4.32 + 1.28) g/L, (4.47 + 1.42) g/L (P0), respectively. .05).5. imaging: there were 67 cases (57.8%), 20 cases of burr sign (17.2%), 40 cases of pleural stretch sign (34.5%), 41 cases of obstructive pulmonary atelectasis (35.3%), 39 obstructive pulmonary disease (33.6%), 12 cases of obstructive pulmonary disease (10.3%), pneumonoid stenosis in 57 cases (33.6%), and lobular syndrome in the lung adenocarcinoma group, and hair in the lung adenocarcinoma group. 32 cases (22.4%), 82 cases (57.3%) of pleural stretch sign, 18 cases of obstructive pulmonary atelectasis (12.6%), 17 cases of obstructive pneumonia (11.9%), 15 cases of vacuoles syndrome (10.5%) and 36 cases of tracheal stenosis obstruction (25.2%), of which the primary foci in the lung squamous cell carcinoma group were obstructive pulmonary atelectasis, obstructive pneumonia, and the proportion of tracheal stenosis was higher than that of lung adenocarcinoma group, with pleural traction. The proportion of the signs was lower than that in the lung adenocarcinoma group (P0.05), the primary focal diameter of the lung squamous cell carcinoma group was (5.15 + 2.40) cm, which was greater than that of the lung adenocarcinoma group (3.73 + 2.10) cm, and the difference was statistically significant (P0.05). The SUVmax value of the lung squamous cell carcinoma was (13.22 + 4.92), higher than that of lung adenocarcinoma (8.94 + 4.06) (P0.05), but in different primary foci Between the size and size of the Sanya group, when the lesion diameter was less than 3cm, the primary SUVmax of the lung squamous cell carcinoma was compared with the large.6. of the lung adenocarcinoma. The primary focus of SUVmax in the lung squamous cell carcinoma group was significantly positively correlated with the size of the primary foci, and the correlation coefficient was 0.31 (P=0.008). The primary focal size of the lung adenocarcinoma group was also positively correlated with the size of the primary focal lesion, and the correlation coefficient was 0.41. (P=0.000): the correlation coefficient of SUVmax and T staging was 0.324 (P=0.005), and the correlation coefficient was 0.066 (P=0.581) and 0.046 (P=0.699), respectively. The correlation coefficient between SUVmax and T staging of lung adenocarcinoma was 0.479 (P=0.000), and the correlation coefficient with N stage was 0.268. The correlation coefficient of the staging was 0.262 (P=0.013) SUVmax and T staging, N staging and M staging. Conclusion: the male proportion and smoking rate in 1. lung squamous cell carcinoma patients were higher than those of lung adenocarcinoma, and there was no significant difference in age composition between lung squamous cell carcinoma and lung adenocarcinoma patients; 2. patients with lung squamous cell carcinoma were associated with bed symptoms (cough, hemoptysis, dyspnea, weight loss). The levels of serum CEA and CA125 in 3. patients with lung adenocarcinoma were higher than those of lung squamous cell carcinoma, and the content of SCCA and CYFRA-21-1 was lower than that of lung squamous cell carcinoma. The serum D- two polymer in the serum of 4. lung adenocarcinoma patients may be higher than that of lung squamous cell carcinoma, and the blood small plate content and Fib concentration in the blood of the lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference; 5. lung squamous cell carcinoma patients The proportion of CT in the chest was obstructive pulmonary atelectasis, obstructive pneumonia, and the proportion of tracheal stenosis was higher than that of lung adenocarcinoma. The proportion of pleural traction in lung adenocarcinoma patients was higher than that of lung squamous cell carcinoma; the primary focal size of lung squamous cell carcinoma was higher than that of lung adenocarcinoma. When the primary diameter was less than 3cm, the SUVmax value of the primary lung cancer patients was higher than that of the lung adenocarcinoma patients; 6. lung squamous cell scale was higher than that of the lung adenocarcinoma. The high and low levels of SUVmax in the cancer group and the lung adenocarcinoma group were significantly correlated with the size of the primary focus, the higher the diameter of the primary focus, the higher the SUVmax value. The higher the SUVmax level in the lung squamous cell carcinoma group was associated with the T staging. The higher the former, the higher the T stage, but it was not associated with the N staging, M staging, and the level of SUVmax in the lung adenocarcinoma group was significantly different from the T staging, N staging, M staging. The higher the SUVmax, the later the stages are.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2
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