中心型肺癌DSA分期探讨与评价

The value of DSA staging for central lung cancer

目的探讨和评价DSA在中心型肺癌临床分期中的应用价值。方法 51例接受介入治疗的中心型肺癌(其中,鳞癌31例,小细胞癌20例)患者,男38例,女13例,年龄41～80岁(中位年龄67岁)。将支气管动脉化疗灌注(BAI)时DSA发现的肿瘤血管与术前肺部增强螺旋CT扫描结果进行对比,分别依据DSA、CT进行TNM分期,比较两种分期方法中≥Ⅲa期及<Ⅲa期肺癌分期之间有无差别,并计算两种检查方法各自的敏感度和特异度。结果 51例术前CT分期≥Ⅲa期18例,<Ⅲa期33例;DSA分期≥Ⅲa期42例,<Ⅲa期9例。CT检查敏感度33.33%,特异度58.33%;DSA敏感度100%,特异度75.00%,二者差异有统计学意义(P<0.05)。结论在中心型肺癌分期中,DSA敏感度和特异度均高于CT,对确定肺癌临床分期与指导治疗有重要价值。

Objective To discuss and evaluate the value of DSA in the clinical staging of central lung cancer. Methods In the 51 central lung cancer patients who took the interventional treatment（squamous cell cancer 31cases,small cell cancer 20 cases） ,age range was from 41 to 80 years old, （average age was 67 years old）.Compared the DSA and CT staging results of ≥Ⅲ a stage and Ⅲ a stage in the 51 patients of central cancer before interventional treatment and analysis the analogic distinction. Results In the 51 central lung cancer patients, 18 cases CT staging were≥ stage Ilia and 33 were staged Ⅲ a. A comparison of DSA to CT, using DSA staging, 42 cases were≥stage Ⅲ a and 9 were staged Ⅲ a. The sensitivity of CT examination was 33.33 %, specificity of CT examination was 58.33 %, On the contraction, the sensitivity of DSA examination is 100 %, the specificity of DSA examination was 75.00 %, there were identification of statistical between the two methods （P〈 0. 05 ）. Conclusion The staging sensitivity and specificity of DSA were better than CT in clinical staging of central lung cancer. Combination of the two methods was better than using single one in clinical staging of central lung cancer.