CT联合基因表达检测对非小细胞肺癌预后的诊断价值

Diagnostic Value of CT Combined Gene Expression Detection in Prognosis of Non-small Cell Lung Cancer

目的:研究增强CT联合Survivin、VEGF基因表达检测在非小细胞肺癌淋巴结转移以及预后中的诊断价值。方法:68例非小细胞肺癌患者术前增强CT扫描,PCR检测术中肿瘤组织中Survivin、VEGF基因的相对表达,分析增强CT与基因表达联合对纵隔淋巴结转移的诊断以及在评价非小细胞肺癌术后复发中的意义价值,通过受试者工作特征曲线(receiver operating characteristic curve,ROC)分析CT联合基因表达检测在判断预后中的敏感性和特异性。结果:Survivin、VEGF基因在纵隔转移淋巴结中的表达要高于非纵隔淋巴结转移中的表达,差异具有统计学意义(P<0.05);术后随访半年中复发组Survivin、VEGF基因的表达要高于未复发组,差异具有统计学意义(P<0.05);在预测纵隔淋巴结转移方面,CT预测的敏感性和特异性分别为70.0%、81.5%,Survivin/VEGF预测的敏感性和特异性分别为86.7%、71.1%,CT联合基因检测预测的敏感性和特异性可达到90.0%、87.8%。结论:Survivin、VEGF基因的高表达可能与纵隔淋巴结转移和术后复发有关,CT联合基因检测可以显著提高纵隔淋巴结转移的检出率,在预测非小细胞肺癌预后中有着重要的临床价值。

Objective To evaluate the diagnostic value of enhanced CT combined with Survivin and VEGF expression in lymph node metastasis and prognosis of non-small cell lung cancer. Methods 68 patients with non-small cell lung cancer received enhanced CT scan before operation. The relative expression of Survivin and VEGF genes in tumor tissues was detected by PCR. The significance of enhanced CT and gene expression in the diagnosis of mediastinal lymph node metastasis and the significance of evaluating the recurrence of non-small cell lung cancer after operation were analyzed. Receiver operating characteristic curve（ ROC） was used to analyze the sensitivity and specificity of CT combined gene expression detection in judging prognosis. Results The expression of Survivin and VEGF in mediastinatic metastatic lymph nodes was higher than that in non-mediastinal lymph node metastasis（ P〈0.05）; The expression of Survivin and VEGF gene in the recurrence group was higher after 6 months of follow-up. In the diagnosis of mediastinal lymph node metastasis,the sensitivity and specificity of CT diagnosis were 70.0%,81.5%,respectively. The sensitivity and specificity of Survivin/VEGF prediction were 86.7%,71.1%,and the sensitivity and specificity of CT combined gene prediction were 90.0% and 87.8%. Conclusion The high expression of Survivin and VEGF may be related to mediastinal lymph node metastasis and postoperative recurrence. CT combined gene detection can significantly improve the detection rate of mediastinal lymph node metastasis and have important clinical value in predicting the prognosis of non-small cell lung cancer.