能谱CT在非小细胞肺癌病理分型中的应用价值

Clinical Value of Spectral CT in Pathological Classification of Non-Small Cell Lung Cancer

目的探究能谱CT对非小细胞肺癌病理分型的临床应用价值。方法择取2017年6月至2019年6月由康平县人民医院收治的90例非小细胞肺癌患者为研究样本,患者入院后均经病理检查确诊,均行能谱CT进行扫描,并以瘤体直径大小进行分组,研究样本被分为A组(12例,直径≤2cm)、B组(78例,直径>2cm),对比两组鳞癌和腺癌患者的动脉期在40~65kev能量下的能谱曲线斜率、碘(水)浓度、水(碘)浓度,以及在平扫40~65kev能量下的能谱曲线斜率、有效原子序列、钙(水)浓度。结果肿瘤直径大小>2cm的腺癌平扫K40~65kev、有效原子序列、钙(水)浓度、腺癌动脉期K40~65kvv、碘(水)浓度、水(碘)浓度均比鳞癌高,差异具有统计学意义(P<0.05);肿瘤直径大小≤2cm的腺癌和鳞癌能谱CT定量参数均无显著差异,P>0.05;结合平扫能谱曲线走势得出鳞癌多数为Ⅰ型、腺癌多数为Ⅱ型。结论对于不同病理分型的非小细胞肺癌患者,其能谱CT定量分析参数具有差异性,肿瘤直径大小>2cm的非小细胞肺癌患者应用能谱CT成像技术可为疾病病理分型提供有效参考。

Objective:To explore the clinical value of spectral CT in pathological classification of non-small cell lung cancer.Methods:A total of 90 patients with non-small cell lung cancer admitted to Kangping People's Hospital from June 2017 to June 2019 were selected as research samples.All patients were confirmed by pathological examination after admission,and all patients were scanned by energy spectrum CT.The tumors were grouped according to the diameter,the study samples were divided into group A(12 cases,diameter≤2cm)and group B(78 cases,diameter>2cm).The slope of energy spectrum curve,iodine(water)concentration,water(iodine)concentration under 40~65kev energy in arterial phase of patients with squamous cell carcinoma and adenocarcinoma were compared between the two groups,and the slope of energy spectrum curve,effective atomic sequence and calcium(water)concentration under 40~65kev energy were compared between the two groups.Results:The K40~65kev,effective atomic sequence,calcium(water)concentration,K40~65kev,iodine(water)concentration and water(iodine)concentration of adenocarcinoma with tumor diameter>2cm were higher than those of squamous cell carcinoma,the difference was statistically significant(P<0.05);there was no significant difference in the quantitative parameters of energy spectrum CT between adenocarcinoma and squamous cell carcinoma with tumor diameter≤2cm,P>0.05.The results showed that most of squamous cell carcinoma was type I and adenocarcinoma was typeⅡ.Conclusion:For NSCLC patients with different pathological types,the quantitative analysis parameters of energy spectrum CT are different.The application of energy spectrum CT imaging technology in patients with non-small cell lung cancer whose tumor diameter is more than 2cm can provide effective reference for pathological classification of disease.