多层螺旋CT对肺癌化疗效果及近期预后的评估价值研究

Study on the value of assessment of MSCT on the chemotherapy effect and short-term prognosis of lung cancer

目的:探讨多层螺旋CT(MSCT)对肺癌化疗效果及近期预后的评估价值。方法:选取医院收治的62例肺癌患者,所有患者均接受化疗治疗,治疗前后采用MSCT扫描仪进行检查并进行灌注CT成像,根据治疗效果分为有效组(28例)和无效组(34例),收集两组治疗前后CT参数及灌注参数,根据实体瘤疗效评价标准(RECIST)进行疗效评价,随访统计无进展生存时间。结果:化疗第1个周期和第6个周期时,肺癌患者治疗总体有效率分别为33.87%和45.16%;所有患者治疗后血容量(BV)、血流量(BF)、表面渗透性(PS)、到达峰值时间(TTP)及肿瘤体积(TV)降低,平均通过时间(MTT)升高,与治疗前比较差异均有统计学意义(t=10.451,t=15.748,t=11.658,t=7.874,t=14.357,t=19.899;P<0.05);治疗前有效组BF及PS高于无效组,TTP及TV低于无效组,差异均具有统计学意义(t=5.135,t=3.246,t=5.539,t=3.916;P<0.05);治疗后有效组BF及MTT高于无效组,TTP及TV低于无效组,差异有统计学意义(t=4.533,t=4.797,t=4.203,t=6.512;P<0.05);PS升高患者中位无进展生存期显著低于PS降低患者,差异有统计学意义(x^(2)=6.420,P<0.05)。结论:MSCT对肺癌疗效及预后有一定评估价值,灌注CT参数值的变化可为肺癌化疗疗效及预后评估提供一定参考。

Objective:To explore the assessment value of multi-slice computed tomography(MSCT)on chemotherapy effect and short-term prognosis of lung cancer.Methods:62 patients with lung cancer who admitted to hospital were selected,and all of them received chemotherapy.The MSCT scanner was used to examine and the perfusion CT imaging was performed before and after treatment.The CT parameters and perfusion parameters before and after treatment were collected.The Response Evaluation Criteria in Solid Tumours(RECIST)were used to evaluate curative effect.Meanwhile,the progression-free survival time was counted as statistic method.Results:The overall effective rates of patients with lung cancer were respectively 33.87%and 45.16%at the 1st cycle and 6th cycles of chemotherapy.After treatment,the blood volume(BV),blood flow(BF),surface permeability(PS),time to peak value(TTP)and tumor volume(TV)of patients decreased,while the mean transit time(MTT)of them increased,the differences of them between before and after chemotherapy were significant(t=10.451,t=15.748,t=11.658,t=7.874,t=14.357,t=19.899,P<0.05),respectively.Before chemotherapy,the BF and PS of the effective group were significantly higher than those of the ineffective group(t=5.135,t=3.246,P<0.05),and the TTP and TV of the former were significantly lower than those of the latter(t=5.539,t=3.916,P<0.05),respectively.After treatment,BF and MTT of the effective group were significantly higher than those of the ineffective group(t=4.533,t=4.797,P<0.05),while the TTP and TV of the former were significantly lower than those of the latter(t=4.203,t=6.512,P<0.05),respectively.The median progression-free survival of the PS rise group was significantly lower than that of the PS decline group(x^(2)=6.420,P<0.05).Conclusion:MSCT has a certain of assessment value in curative effect and prognosis of lung cancer,and the changes of perfusion CT parameters can provide a certain of reference for chemotherapy effect and prognosis assessment of lung cancer.