螺旋CT三维定量测量评估I期非小细胞肺癌肿瘤大小及T分期的价值

Three-dimensional Quantitative Measurement of Spiral CT in Evaluating Tumor Size and T Stage of Stage I Non-small Cell Lung Cancer

目的探讨螺旋CT三维定量测量评估I期非小细胞肺癌(NSCLC)肿瘤最大径及术前T分期的价值。资料与方法 125例经手术病理证实的I期NSCLC患者,均有完整的CT检查资料,评估CT三维定量测量与二维测量、大体病理测量肿瘤最大径及T分期的差异。结果 CT三维定量测量、二维测量及大体病理测量125例患者的肿瘤平均最大径分别为(26.21±8.14)mm、(27.03±9.90)mm、(25.60±9.31)mm;二维测量与三维定量测量、大体病理测量肿瘤最大径差异均有统计学意义(t=2.377,P<0.05;t=2.961,P<0.01),三维定量测量与大体病理测量肿瘤最大径差异无统计学意义(t=1.281,P>0.05);Bland-Altman分析显示,以大体病理测量结果作为"金标准",三维定量测量较二维测量一致性更高;在此基础上,以三维定量测量结果为对照,有25例(20%)二维测量分期结果与其不一致。结论螺旋CT三维定量测量对I期NSCLC肿瘤最大径测量及术前分期结果较二维测量更准确,可以为NSCLC患者术前分期、评估预后和疗效提供更准确的评价标准。

Purpose To investigate the value of three-dimensional quantitative measurement of spiral CT in evaluating tumor size and preoperative T stage in stage 1 non-small cell lung cancer （NSCLC）. Materials and Methods The complete data of 125 patients with stage I NSCLC confirmed surgically and pathologically were compared in terms of maximum tumor diameter and T stage analysis by means of three-dimensional quantitative CT measurement, two-dimensional measurement and general pathology measurement. Results The mean maximum tumor diameter of these 125 patients measured by quantitative three-dimensional CT measurement two-dimensional measurement and general pathology measurement were （26.21 ± 8.14） mm, （27.03 ± 9.90） mm and （25,60±9.31） mm, respectively. The difference in mean maximum tumor diameter by two-dimensional measurement and three-dimensional quantitative measurement was significant, and remained so when two-dimensional measurement and pathology measurement was compared （t=-2.377, P〈0.05; t=2.961, P〈0.01）, but that between three- dimensional quantitative measurement and pathology measurement was not significant （t=1.281, P〉0.05）. Bland-Altman analysis showed that three-dimensional quantitative measurement had higher consistency than two-dimensional measurement when compared with the gold standard pathology measurement. When three-dimensional quantitative measurement was taken to be the staging criterion, 20% results （25 cases） obtained by two-dimensional measurement proved to be inconsistent. Conclusion Compared with two-dimensional measurement, quantitative three-dimensional CT measurement can provide more accurate information in maximum tumor diameter and T stage for patients with stage 1 NSCLC, theretbre can be applied as a more accurate criterion in preoperative staging and prognosis of stage I NSCLC.