| 刘干辉， 程英， 刘雪艳， 张红平， 孟志华.早期非小细胞肺癌生存因素的CT初步研究[J].放射学实践,2014,(07):782-785 |
| 早期非小细胞肺癌生存因素的CT初步研究 |
| A preliminary study of survival factors in early non small cell lung cancer using CT |
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| DOI：10.13609/j.cnki.1000 0313.2014.07.013 |
| 中文关键词: 小细胞肺癌 存活率分析 体层摄影术，X线计算机 |
| 基金项目:广东韶关市卫生局科研立项项目（Y13201）；韶关科技计划项目（2014CX/K205） |
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| 【摘要】 目的：探讨肺癌复发危险因素中病灶血管分型、强化后CT增值、大小与早期非小细胞性肺癌（ENSCLC）复发的相关性及患者生存时间的相对危险度（RR）。方法:回顾性分析520例肺癌患者（145例术后复发，375例术后未复发）的临床资料，所有患者均行CT平扫及增强扫描，并根据CT结果对病灶进行血管分型，计算病灶强化后CT增值及病灶体积。采用Logistic回归分析筛选肺癌术后复发危险因素。分析其中的130例ENSCLC患者的病灶血管分型、强化后CT增值及大小与肺癌复发的相关性，采用Cox模型对ENSCLC患者进行生存分析。结果：肺癌复发危险因素中病灶血管分型、强化后CT增值、体积的OR值分别为5.40、3.51、8.94，χ2值分别为4.13、6.94、3.18，P值均＜0.05。对ENSCLC患者术后复发率进行比较：Ⅳ型血管分型的肺癌复发率明显低于Ⅰ型、Ⅱ型和Ⅲ型（χ2分别为9.018、6.994、6.211，P值均＜0.05）；病灶强化后CT增值≤20HU的肺癌复发率明显低于20～60HU和≥60HU的患者（χ2值分别为6.936、13.306，P值分别为0.008、0.000）；病灶直径2～3cm的肺癌复发率明显大于直径≤2cm的患者（χ2=4.811，P=0.028）。经Cox模型生存分析，ENSCLC中病灶血管分型、强化后CT增值、肺癌直径的RR分别为0.335、2.152、2.014（P值均＜0.05）。结论：肺癌复发的危险因素包括病灶血管分型、强化后CT增值及体积，这些危险因素与ENSCLC的复发及患者生存时间相关。 |
| 【Abstract】Objective：To investigate the correlation of the risk factors of recurrence including blood vessel pattern,net enhanced CT value and size of lesion,and the relative risk (RR) of survival time in early non-small cell lung cancer （ENSCLC） by CT scanning.Methods：The clinical materials of 520 patients with lung cancer were retrospectively analyzed,including 145 patients with recurrence after surgery and 375 patients with no recurrence.All had plain and enhanced CT.The blood vessel pattern,net enhanced CT value and lesion size displayed on CT were studied.The risk factors of lung cancer recurrence were measured and calculated by logistic regressive analysis.Of 130 ENSCLC patients,the correlation of lung cancer recurrence with blood vessel pattern,net enhanced CT value and size of lesion were analyzed,the survival analysis was carried out with Cox model regression.Results：As for the risk factors of ENSCLC recurrence,the odds radio （OR） value was 5.40,3.51,8.94,respectively for blood vessel pattern,net enhanced CT value and size of tumor,with significant statistical differences （χ2=4.13,6.94,3.18,P<0.05）.For ENSCLC patients after surgery,the recurrence rate of type Ⅳ blood vessel pattern was obviously lower than that of type Ⅰ,Ⅱ and Ⅲ,with significant statistic differences （χ2=9.018,6.994,6.211,P<0.05）.The recurrence rate of ENSCLC with net enhanced CT value ≤20HU was markedly lower than that of 20～60HU,and ≥60HU （χ2=6.936,13.306 respectively,P=0.008 and 0.000 respectively）.The recurrence of lesion with size as 2~3cm was obviously higher than that of size ≤2cm （χ2=4.811,P=0.028）.With Cox model survival analysis,there were statistically significant differences for blood vessel pattern,net enhanced CT value,and size of lesion (P<0.05),the relative risk (RR)=0.335,2.152,2.014,respectively.Conclusion：The risk factors of lung cancer recurrence include vessel types,net enhance value,and lesion size,further,these factors are correlated with ENSCLC recurrence and survival time of patients. |
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