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

摘要：

目的　分析128排CT灌注成像在浸润性肺腺癌患者术后复发预测中的临床价值。方法　选取2021年3月至2023年3月在荥阳市人民医院就诊的100例浸润性肺腺癌患者。术后对患者进行为期12个月的随访，根据疾病是否复发，将患者分为复发组（30例）和未复发组（70例）。复发组男16例，女14例；年龄（52.62±5.66）岁；体重指数（BMI）（24.62±0.94）kg/m²。未复发组男38例，女32例；年龄（52.33±5.05）岁；BMI（24.68±0.84）kg/m²。收集两组一般资料；比较两组128排CT灌注成像参数［血容量（BV）、血流量（BF）、表面通透性（PS）、对比剂达峰时间（TTP）、对比剂平均通过时间（MTT）］；logistic回归分析浸润性肺腺癌患者术后复发的危险因素；采用受试者操作特征曲线（ROC）分析128排CT灌注成像参数对浸润性肺腺癌患者术后复发的预测效能。采用独立样本t检验和χ²检验。结果　复发组PS低于未复发组（P<0.05），复发组对比剂TTP、MTT均高于未复发组（均P<0.05）。logistic回归分析显示，PS、对比剂MTT、对比剂TTP、淋巴结转移、分化程度均是浸润性肺腺癌患者术后复发的影响因素（均P<0.05）。PS、对比剂MTT、对比剂TTP联合预测浸润性肺腺癌患者术后复发的曲线下面积（AUC）（95%CI）为0.850（0.801～0.936）。三者联合预测浸润性肺腺癌患者术后复发的灵敏度（93.08%）均高于单独检测（75.82%、68.25%、66.96%）（均P<0.05）。结论　浸润性肺腺癌患者术后复发可引起PS降低和对比剂MTT、对比剂TTP增长；PS、对比剂MTT、对比剂TTP联合检测可提高对术后复发预测的灵敏度，具有重要指导意义。

关键词:

浸润性肺腺癌, 128排CT灌注成像, 复发, 危险因素