NSCLC淋巴结转移与肿瘤血容量之间关系的研究

The relationship between lymphatic metastasis and tumor blood volume in NSCLC

目的使用宝石能谱CT测得的肿瘤平均碘浓度来观察非小细胞肺癌(NSCLC)患者纵隔淋巴结转移和肿瘤血容量的关系。方法对45例经病理证实的周围型NSCLC患者行GE宝石能谱CT扫描来作为治疗前评估,设定肿瘤给定空间位置的感兴趣区,将测得的肿瘤平均碘浓度与肿瘤大小进行相关分析,并比较有无淋巴结转移的肿瘤平均碘浓度之间及其肿瘤大小之间的差异。结果随着肿瘤的增大,平均碘浓度是降低的(P <0. 05)。有淋巴结转移与无淋巴结转移的肿瘤相比,肿瘤内平均碘浓度降低(P <0. 05),肿瘤直径增大(P <0. 05)。结论平均碘浓度所表征的肿瘤相对血容量可能是对肿瘤内缺氧细胞群所驱动的淋巴结转移的一种无创定量评估方式。

Objective To investigate the relationship between lymphatic metastasis and tumor blood volume in patients with non-small cell lung cancer （NSCLC） using the average iodine density of tumors measured by Gemgstone Spectral CT. Methods Forty-five patients with peripheral NSCLC confirmed by pathology underwent enhanced CT with Gemgstone Spectral Imaging （GSI） mode for pretreatment evaluations. The region-of-interest for a given spatial placement of the tumors was set, and average iodine density of tumors was compared with the tumor sizes. And we explored the relationship between the metastasis of lymph nodes and average iodine density, as well as the tumor sizes. Results As the tumor size increased, the average iodine density was decreased （ P 〈 0. 05）. The average iodine density of tumors with lymphatic metastasis was lower than that without lymphatic metastasis （ P 〈 0.05）. The tumors with lymphatic metastasis were larger than those without lymphatic metastasis （ P 〈 0.05）. Conclusion The average iodine density may be a non-invasive and quantitative assessment of lymphatic metastasis driven by hypoxic cells in tumors.