低剂量容积灌注CT在晚期肺腺癌患者EGFr-TKI治疗随访中的应用价值分析

Utility of Low-dose Volume-perfusion CT in the Follow-up of Patients with Advanced Lung Adenocarcinoma Treated with Egfr-tki

目的:探讨低剂量容积灌注CT在晚期肺腺癌患者EGFr-TKI治疗随访中的应用效果。方法:选取2018年1月至2019年4月期间我院收治的晚期肺腺癌采取EGFr-TKI治疗患者共计60例。其中男性32例,女性28例。年龄56-84(68.4±8.7)岁。所有患者在进行EGFr-TKI治疗之前都进行低剂量容积灌注CT检查,并在治疗6周后按照统一设定值再次进行低剂量容积灌注CT检查随访,测量肿瘤的血流量(BF),以此评价肿瘤的变化情况,并且参照RECIST1.1疗效评价作为对比,观察低剂量容积灌注CT在晚期肺腺癌患者EGFr-TKI治疗随访中的临床效果。结果:应用EGFr-TKI治疗的患者中,部分缓解30例,病灶稳定16例,病灶进展14例。低剂量容积灌注CT血流量变化情况与RECIST疗效评价的结果呈线性相关,预测病灶进展的敏感性为92.8%、特异性为82.6%、准确性为85.0%、阳性预测值为61.9%,阴性预测值为97.4%。结论:低剂量容积灌注CT在晚期肺腺癌患者EGFr-TKI治疗随访中具有一定的应用价值,值得在临床推广。

Objective:To investigate the efficacy of low-dose volume-perfusion CT in the follow-up of patients with advanced lung adenocarcinoma who treated with EGFr-tki.Methods:A total of 60 patients with advanced lung adenocarcinoma treated with EGFr-tki from March 2018 to April 2019 were selected.There were 32 males and 28 females.Age:56-84(68.4±8.7)years.All patients underwent low-dose volume perfusion CT examinations before EGFr-TKI treatment,and low-dose volume perfusion CT examination again 6 weeks after treatment.The blood flow(BF)of tumors was measured to evaluate the changes of tumors and compared with RECIST 1.1.In order to observe the clinical effect of low dose volume perfusion CT in the follow-up of patients with advanced lung adenocarcinoma treated with EGFr-TKI.Results:Among the patients treated with egfr-tki,there were 30 patients with partial remission,16 stable patients,and 14 progressive patients.The results of low-dose volume perfusion CT showed a linear correlation with the results of RECIST efficacy evaluation.The sensitivity,specificity and accuracy of follow-up to predict PD were 92.8%,82.6%,85.0%,61.9%and 97.4%respectively.Conclusion:Low-dose volume perfusion CT has high application value in the follow-up of EGFr-TKI treatment of advanced lung adenocarcinoma patients,and is worthy of clinical promotion.