核磁荧光双模态不同分子探针判断非小细胞肺癌病情与预测预后的价值

The Values of NMR Fluorescence Dual Modal Probes in Predicting the Grade and Prognosis of Non-small Cell Lung Cancer

目的探讨核磁荧光双模态不同分子探针判断非小细胞肺癌(NSCLC)病情与预测预后的价值。方法选择NSCLC患者64例作为研究对象,所有患者都给予核磁荧光双模态不同分子探针-氢质子磁共振波谱(1H-MRS)检查,记录影像学特征;随访预后,调查影响预后的因素。结果在64例患者中,常规MRI表现为不均匀强化,周围T2上高信号,肿瘤边界不清,瘤周水肿显著。NSCLC的肿瘤实质区典型波谱表现为Cho峰显著升高,NAA峰显著降低,Cr峰降低不显著,NAA/Cr比值降低,Cho/NAA、Cho/Cr比值升高,与对侧正常区对比差异有统计学意义(P <0. 05)。低级别组瘤体区的Cho/NAA、Cho/Cr、NAA/Cr比值与高级别组对比差异也有统计学意义(P <0. 05)。随访至2018年4月,64例患者中死亡12例,死亡率为18. 8%。多因素Logistic回归分析结果显示:病情分级、Cho/Cr、Cho/NAA为导致患者死亡发生的主要危险因素(P <0. 05)。结论核磁荧光双模态不同分子探针可有效判断NSCLC患者的病情与预测预后,有很好的临床应用价值。

Objective To explore the values of NMR fluorescence dual mode probes in the diagnosis of grade and prognosis of non-small cell lung cancer( NSCLC). Methods 64 patients with NSCLC were selected. All the patients were given NMR fluorescence dual modal probes-hydrogen proton magnetic resonance spectroscopy( 1 H-MRS),and the imaging features were recorded and were to investigate the factors that affected the prognosis. Results In the 64 patients,the conventional MRI were more showed uneven enhancement,high signal around T2,unclear tumor border and significant edema around the tumor. The typical spectrum of the tumor parenchyma of NSCLC showed significant increased in Cho peak,the decreased of NAA peak,the decreased of NAA/Cr ratio,the increase of Cho/NAA and Cho/Cr ratio,and there were statistically significant difference compared with the contralateral normal region( P < 0. 05). The Cho/NAA,Cho/Cr and NAA/Cr ratios in the low level group were also significantly different from those of the advanced group( P < 0. 05). Up to April 2018,12 patients were died,with the mortality rate of 18. 8%. Multivariate Logistic regression analysis showed that disease grade,Cho/Cr and Cho/NAA were the main risk factors leading to the death of patients( P < 0. 05). Conclusion NMR fluorescence dual modal probes can effectively predict the grade and prognosis of NSCLC patients.