非小细胞肺癌颅内转移瘤CT灌注参数与病理类型、TTF-1及腺癌EGFR突变相关性的初步研究

A preliminary study on the correlation between CT perfusion parameters of intracranial metastatic non-small cell lung cancer and pathological type,TTF-1 and EGFR mutation in adenocarcinoma

目的探讨非小细胞肺癌(NSCLC)颅内转移瘤CT灌注(CTP)参数与病理类型、肺腺癌免疫指标TTF-1以及肺腺癌EGFR基因突变的相关性。方法选取NSCLC IV期颅脑转移患者45例,包括腺癌30例(TTF-124例阳性、6例弱阳性,EGFR基因突变类型野生型11例、21因子突变11例,19因子突变8例),鳞癌15例(TTF-115例阴性),对其进行颅内转移瘤CT灌注成像,分析灌注参数与肺癌病理类型、肺腺癌常见EGFR突变类型(19、21因子突变及基因野生型)及TTF-1的相关性。结果腺癌与鳞癌颅内转移瘤在灌注参数CBF与MTT差异有统计学意义(P=0.001);肺腺癌EGFR基因野生型与21因子突变在CBV(P=0.009)、CBF(P=0.014)上差异有统计学意义,基因野生型与EGFR19因子突变型在MTT(P=0.010)上差异有统计学意义;MTT与TTF-1存在负相关,CBF与TTF-1存在正相关。结论肺腺癌、鳞癌颅内转移瘤CT灌注参数及肺腺癌EGFR常见突变类型灌注参数存在差异,CT灌注成像可以辅助晚期肺癌患者的诊断。

Objective To investigate the correlation between CT perfusion(CTP)parameters of intracranial metastases in non-small cell lung cancer(NSCLC)and pathological type,immune index TTF-1 and EGFR gene mutation in lung adenocarcinoma.Methods Forty-five patients with NSCLC stage IV craniocerebral metastases were prospectively collected in our hospital from December 2019 to March 2021.There were 30 cases of adenocarcinoma(24 positive cases of TTF-1,6 weak positive cases of TTF-1,11 cases of wild-type mutation of EGFR,11 cases of factor 21 mutation,and 8 cases of factor 19 mutation),and 15 cases of squamous carcinoma(15 negative cases of TTF-1).CT perfusion imaging of intracranial metastatic tumor was performed,and the correlation of perfusion parameters with pathological types of lung cancer,common EGFR mutations(factor 19,21 mutations and wild-type gene)and TTF-1 was determined.Results There was statistically significant difference in the perfusion parameters of CBF and MTT between intracranial metastatic adenocarcinoma and squamous cell carcinoma(P=0.001).In lung adenocarcinoma,there were statistically significant differences between wild type EGFR gene and factor 21 mutation in CBV(P=0.009)and CBF(P=0.014),and statistically significant differences between wild type EGFR gene and EGFR19 mutation in MTT(P=0.010).MTT was negatively correlated with TTF-1,while CBF was positively correlated with TTF-1.Conclusion CT perfusion parameters of lung adenocarcinoma,intracranial metastatic tumor of squamous cell carcinoma and common mutations of lung adenocarcinoma EGFR are different,and CT perfusion imaging can assist the diagnosis of advanced lung patients.