NSCLC患者胸部CT征象及其与预后的相关性分析

Correlation Analysis of Chest CT Signs and Prognosis in Patients with NSCLC

目的探究非小细胞肺癌(NSCLC)患者胸部CT征象及其与预后之间关系。方法回顾性分析2013年8月至2016年8月期间收治92例NSCLC患者相关资料,均进行CT检查,随后接受为期3年随访判断患者预后。分析患者胸部CT征象表现以及比例,患者预后情况,影响患者预后单因素与多因素分析。结果CT检查可以清楚显示病灶密度、边缘与胸膜之间关系以及病灶血管等相关征象情况;患者中位随访时间为42.6个月,3年随访时间内死亡19例,存活73例,3年累积存活率为79.35%;预后不同患者在性别、TNM分期、病灶边缘情况与胸膜关系以及病灶血管征象方面差异存在统计学意义(P<0.05),预后不同患者在年龄、病理类型、病灶密度、其他征象等方面差异无统计学意义(P>0.05);多元Logistic回归显示,TNM分期ⅢB期、病灶边缘不光滑以及病灶与胸膜关系异常是导致患者预后情况不佳危险因素(P<0.05),而性别与病灶血管征象异常不是影响患者预后危险因素(P>0.05)。结论NSCLC患者胸部CT征象中病灶边缘不光滑以及与胸膜关系异常等都为导致患者预后情况不佳的重要危险因素。

Objective To explore chest CT findings and their relationship with prognosis in patients with non-small cell lung cancer(NSCLC). Methods A retrospective analysis was performed on related data of 92 NSCLC patients who were admitted from August 2013 to August 2016. All underwent CT examination and then were followed up for 3 years to determine their prognosis. The findings and proportion of chest CT, and prognosis were analyzed. Univariate and multivariate analysis were applied to analyze factors affecting prognosis. Results CT examination could clearly show density and margins of lesions, their relationship with pleura, and lesion vessels related signs. The median follow-up time was 42.6 months. There were 19 patients died and 73 patients survived during 3-year follow-up. The 3-year cumulative survival rate was 79.35%. There were significant differences among patients with different prognosis in terms of gender, TNM stages, lesions margin, their relationship with pleura and vascular signs of lesions(P<0.05), while there was no significant difference in age, pathological types, lesion density or other signs(P>0.05). The multiple Logistic regression showed that TNM staging at stage ⅢB, nonsmooth margins of lesions, and abnormal relationship between lesions and pleura were risk factors leading to poor prognosis(P<0.05), while gender and abnormal vascular signs of lesions were not risk factors(P>0.05). Conclusion In chest CT findings of NSCLC patients, non-smooth margins of lesions and abnormal relationship with pleura are important risk factors that lead to poor prognosis.