胸部CT征象对老年周围型非小细胞肺癌脑转移的预测分析

The predictive value of chest CT signs for brain metastases in elderly patients with peripheral non-small cell lung cancer

目的分析胸部CT征象与老年周围型非小细胞肺癌(non-small cell lung cancer,NSCLC)患者发生脑转移的相关性,探讨CT征象预测脑转移的可能性。方法选择2012年2月至2017年2月于本院治疗的95例老年周围型NSCLC患者为研究对象,其中51例发生脑转移,44例未发生脑转移。回顾性分析患者的基本资料和胸部CT征象,并通过单因素和多因素Logistic回归分析探讨胸部CT征象与脑转移发生的相关性。结果单因素分析显示,肿瘤病理类型为老年周围型NSCLC患者发生脑转移的相关因素(P<0.05)。胸部CT征象单因素分析显示,肿瘤毛刺征、空泡空洞征、空气支气管征、胸膜凹陷征及CT-T/N分期是老年周围型NSCLC患者发生脑转移的相关因素(P<0.05)。多因素Logistic回归分析显示,腺癌、CT-T_2和T_4期、CT下空气支气管征、毛刺征、Ⅱ型和Ⅳ型胸膜凹陷征为脑转移发生的独立危险因素(P<0.05)。结论胸部CT下病理类型、CT-T_2和T_4分期、CT下空气支气管征、毛刺征以及Ⅱ型和Ⅳ型胸膜凹陷征对老年周围型NSCLC患者脑转移的发生具有较高的预测价值,可重点关注以指导早期治疗。

Objective To investigate the predictive value of chest CT signs for brain metastases in elderly patients with peripheral non-small cell lung cancer(NSCLC).Method From February2012to February2017,95elderly patients with peripheral NSCLC were enrolled in this study.51patients had brain metastases,while44cases had no brain metastases.All patients'basic data and chest CT signs were retrospectively analyzed.Then we explored the predictive value of chest CT signs for brain metastases by single factor and multivariate Logistic regression.Result Single factor analysis showed that the tumor pathological types were related factors of brain metastases in elderly peripheral NSCLC patients(P<0.05).Univariate analysis showed that the pathological types,spiculation sign,cavity and vacuole sign,air bronchial sign,pleural indentation sign and CT-T/N radiological tumor staging were related factors of brain metastases(P<0.05).Multivariate Logistic regression analysis showed that adenocarcinoma,CT-T2and T4staging,air bronchial sign,spicular sign and pleural indentation sign(typeⅡandⅣ)were the independent risk factors of brain metastasis(P<0.05).Conclusion The pathological types,CT-T2and T4staging,air bronchial sign,spicular sign and pleural indentation sign(typeⅡandⅣ)have high predictive value for brain metastases in elderly patients of peripheral non-small cell lung cancer,which can be noticed to guide the early therapy.