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(P<0.01)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%,P<0.01),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%,P<0.01)。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。
Objective：To investigate the role of three-dimensional computer quantified CT number analysis in the estimation of prognosis of pathological stage I pulmonary adenocarcinoma. Methods：The HRCT, clinical and pathological data of 114 patients with stage I lung adenocarcinoma who underwent surgical resection in our hospital from January 2005 to December 2012 were retrospectively analyzed. Three-dimensional computer quantified CT number analysis software was used to calculate the proportion of the ground glass opacity （GGO） components and the solid components in the tumor. According to the follow-up results, the patients were divided into progressive group and disease-free survival group. The difference of the clinical,pathologic and HRCT features of the two groups were compared. Multivariate cox regression analysis was used to identify the independent factors. The receiver operating characteristic curve （ROC） was used to determine the critical value of the proportion of the GGO component and the solid component in predicting tumor progression. The disease-free survival （DFS） in different GGO component proportion and solid component proportion was estimated using the Kaplan-meier methods and Log-rank test. Results： Of the 114 patients with stage I lung adenocarcinoma, there were 51 patients in the progression group, and 63 in the disease-free survival group. The 5 years disease-free survival rate was 55.3 %. Statistically significant differences in gender, smoking status, pathological score, lepidic growth pattern percentage, type of the tumor,GGO component proportion and solid component proportion were detected in the two groups （P^0.05）. Multi- variate analysis indicated that the GGO component proportion （P=0. 04） and the solid component proportion （PGO. 01） were correlated with the prognosis, and the cut-off values were 0.13 and 0.47, respectively. The patients with GGO compo- nent proportion ~0.13 had a much higher DFS rate （76%） than those with 〈0.13 （39. 1%）（P〈0.01）. The patients with solid component proportion ~0.47 had a much lower DFS rate （33. 3%） than those with 〈0.47 （82.4%）（P〈0. 01）. Conclusion：The proportion of GGO components and the proportion of solid components calculated by three-dimensional computer quantified CT number analysis could be used to predict the prognosis of early-stage lung adenocarcinoma.
出处
《放射学实践》
北大核心
2017年第6期593-597,共5页
Radiologic Practice
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)
关键词
肺肿瘤
腺癌
体层摄影术
X线计算机
预后
Lung neoplasms
Adenocarcinoma
Tomography,X-ray computed
Prognosis
