关键词:

浸润性肺腺癌, 128排CT灌注成像, 复发, 危险因素

Abstract:

Objective　To analyze the clinical value of 128-slice CT perfusion imaging in predicting postoperative recurrence in patients with invasive lung adenocarcinoma. Methods　A total of 100 patients with invasive lung adenocarcinoma were selected from March 2021 to March 2023 in Xingyang People's Hospital. The patients were followed up for 12 months after surgery, and were divided into a recurrence group (30 cases) and a non-recurrence group (70 cases) according to whether the disease recurred. In the recurrence group, there were 16 males and 14 females, aged (52.62±5.66) years, with a body mass index (BMI) of (24.62±0.94) kg/m². There were 38 males and 32 females in the non-recurrence group, aged (52.33±5.05) years, with a BMI of (24.68±0.84) kg/m². The general data of the two groups were collected, and the parameters of 128 slice CT perfusion imaging [blood volume (BV), blood flow (BF), surface permeability (PS), time to peak of contrast agent (TTP), and mean transit time of contrast agent (MTT)] were compared between the two groups. Logistic regression analysis was performed to identify the risk factors of postoperative recurrence in patients with invasive lung adenocarcinoma. The receiver operating characteristic curve (ROC) was used to analyze the predictive efficacy of 128 slice CT perfusion parameters for postoperative recurrence in patients with invasive lung adenocarcinoma. Independent sample t test and χ² test were used. Results　The PS in the recurrence group was lower than that in the non-recurrence group (P<0.05), and the contrast agent TTP and MTT in the recurrence group were higher than those in the non-recurrence group (both P<0.05). Logistic regression analysis showed that PS, contrast agent MTT, contrast agent TTP, lymph node metastasis, and differentiation degree were all influencing factors for postoperative recurrence in patients with invasive lung adenocarcinoma (all P<0.05). The area under the curve (AUC) (95%CI) of combination of PS, contrast agent MTT, and contrast agent TTP in predicting postoperative recurrence in patients with invasive lung adenocarcinoma was 0.850 (0.801-0.936). The sensitivity (93.08%) of combination of the three to predict postoperative recurrence of invasive lung adenocarcinoma was higher than that of single detection (75.82%, 68.25%, and 66.96%) (all P<0.05). Conclusions　Postoperative recurrence in patients with invasive lung adenocarcinoma can lead to a decrease in PS and an increase in contrast agent MTT and TTP. The combined detection of PS, contrast agent MTT, and contrast agent TTP can improve the predictive sensitivity of postoperative recurrence, which has important guiding significance.

Key words:

Invasive lung adenocarcinoma, 128-slice CT perfusion imaging, Recurrence, Risk factors