肺癌脑转移瘤瘤周水肿程度的影响因素研究

Factors of the edema-size of intracranial metastases from lung cancer

目的 研究影响肺癌脑转移瘤瘤周水肿程度的因素。方法 回顾性分析经手术病理和／或临床证实的肺癌脑转移瘤MRI资料26例（男13例，女13例，年龄34～75岁，平均57．71岁），所有患者均进行增强扫描。从断层像上观察瘤灶在脑内的分布情况，分别观察记录：瘤周水肿的大小、瘤灶的大小、瘤灶中心到最近灰质边缘的距离、瘤灶的强化特点（均匀强化、不均匀强化和环状强化）、瘤灶在脑内分布（大脑半球、小脑和脑干）的情况等，同时记录瘤灶的组织学类型（小细胞肺癌和非小细胞肺癌）、患者的年龄和性别。以瘤灶瘤周水肿的大小为应变量，以性别、年龄、组织学类型、瘤灶大小、瘤灶中心到最近灰质边缘的距离、瘤灶的强化类型、瘤灶的部位为自变量，进行多因素相关性分析。结果 ①26例肺癌脑转移瘤病人中，肺癌组织学类型为小细胞肺癌8例，非小细胞肺癌18例，共包括92个瘤灶。92个瘤灶中，瘤周水肿的大小为0～5．1cm，瘤灶大小为0．2～5．0cm，瘤灶中心到最近灰质边缘的距离为0．1～2．5cm，均匀强化、不均匀强化和环状强化分别为40个、13个和39个，大脑半球、小脑和脑干分别为72个、17个和3个。②瘤灶瘤周水肿程度与瘤灶大小、与灰质边缘的距离及部位有相关性，且与瘤灶大小、与灰质边缘的距离成正相关，与部位成负相关（F=20．04，P＜ 0．0001）。结论 肺癌脑转移瘤瘤周水肿程度与瘤灶大小、瘤灶中心到最近灰质边缘的距离和瘤灶分布部位有关，与瘤灶的强化类型、组织学类型、性别和年龄无关。

Objective To study the influential factors of the edema-size of the intracranial metastases from lung cancer. Methods Twenty-six patients （13 male and 13 female, mean age 55.71 years, range from 34 to 75 years,） with pathologically/ clinically proved intracranial metastases from lung cancer were reviewed retrospectively. All cases underwent plain and contrast-enhanced scanning, emphases were focused on the followings： the diameter of metastases, the distance from the tumor center to the nearest cortex wall, enhanced features, the sex, age and histological type. The above 7 variables were investigated by multiple factor analysis. Results ①Among 26 cases, 8 cases were small cell lung cancer, 18 cases were nonsmall cell lung cancer. Ninety-two metastases were found in 26 cases, edema-size ranged 0-5.1 cm; the diameter of metastases ranged 0.2-5.0 cm; the distance from the tumor center to the nearest cortex wall ranged 0.1 -2.5 cm. Forty metastases were homogeneous enhanced, 13 metastases were heterogeneous enhanced, 39 metastases were ring-like enhanced. ② Multiple factor analysis indicated that the influential factors of the edema-size of the metastases were the diameter of metastases, the distance from tumor center to nearest cortex wall, and the site of the metastases （F= 20.04, P〈0. 0001）. Conclusion The diameter of metastases, the distance from the tumor center to the nearest cortex wall, and the site of the metastases were the influential factors of the edema-size of the intracranial metastases from lung cancer.